How much rates vary
Facilitymedian $2,344 · 10th to 90th $708 to $8,710Professionalmedian $1,349 · 10th to 90th $794 to $6,918
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $2,454.71 | Professional | None | $741.31 | $741.31 | $2,454.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $575.44 Median $3,388.44 Typical High $10,232.93 | Facility | None | $575.44 | $3,388.44 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $912.01 Median $1,949.84 Typical High $6,918.31 | Professional | None | $912.01 | $1,949.84 | $6,918.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,819.70 | Professional | None | $831.76 | $831.76 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,165.95 Typical High $9,332.54 | Facility | None | $676.08 | $6,165.95 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,071.52 | $2,137.96 |
Fallon Health Setting Facility Modifier None Typical Low $794.33 Median $1,047.13 Typical High $3,311.31 | Facility | None | $794.33 | $1,047.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,230.27 | Professional | None | $912.01 | $1,071.52 | $1,230.27 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,454.71 | Professional | None | $891.25 | $1,659.59 | $2,454.71 |
Health New England Setting Facility Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $20,892.96 | Facility | None | $9,772.37 | $9,772.37 | $20,892.96 |
Health New England Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $575.44 Median $3,388.44 Typical High $10,232.93 | Facility | None | $575.44 | $3,388.44 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $912.01 Median $1,949.84 Typical High $6,918.31 | Professional | None | $912.01 | $1,949.84 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $14,125.38 | Facility | None | $1,071.52 | $3,467.37 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $3,548.13 | Professional | None | $1,000.00 | $1,348.96 | $3,548.13 |
Well Sense Setting Facility Modifier None Typical Low $676.08 Median $1,047.13 Typical High $3,388.44 | Facility | None | $676.08 | $1,047.13 | $3,388.44 |
Well Sense Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | None | $616.60 | $616.60 | $831.76 |
7 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $371.54 Typical High $1,230.27 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $501.19 | Professional | 53 · Discontinued | $147.91 | $147.91 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $1,862.09 | Professional | 54 · Surgery only | $549.54 | $549.54 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $371.54 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $245.47 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $1,737.80 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,148.15 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $660.69 | $1,148.15 | $1,513.56 |
Where Massachusetts sits
The same service costs 5.7 times more in Colorado than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $14,031HI $2,469
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.