How much rates vary
Facilitymedian $603 · 10th to 90th $309 to $2,818Professionalmedian $776 · 10th to 90th $417 to $1,905
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 $1,000.00 Median $2,187.76 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $1,047.13 | Professional | None | $371.54 | $416.87 | $1,047.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $199.53 Median $794.33 Typical High $2,818.38 | Facility | None | $199.53 | $794.33 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $426.58 Median $891.25 Typical High $3,801.89 | Professional | None | $426.58 | $891.25 | $3,801.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $489.78 Median $588.84 Typical High $1,122.02 | Facility | None | $489.78 | $588.84 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $1,659.59 | Facility | None | $446.68 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,174.90 | Professional | None | $588.84 | $660.69 | $1,174.90 |
Fallon Health Setting Facility Modifier None Typical Low $478.63 Median $616.60 Typical High $3,311.31 | Facility | None | $478.63 | $616.60 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $912.01 | Professional | None | $676.08 | $776.25 | $912.01 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,584.89 | Professional | None | $512.86 | $1,000.00 | $1,584.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $199.53 Median $794.33 Typical High $2,818.38 | Facility | None | $199.53 | $794.33 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $426.58 Median $891.25 Typical High $3,801.89 | Professional | None | $426.58 | $891.25 | $3,801.89 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,630.78 | Facility | None | $123.03 | $549.54 | $3,630.78 |
United Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,905.46 | Professional | None | $446.68 | $676.08 | $1,905.46 |
Well Sense Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $776.25 | Facility | None | $331.13 | $501.19 | $776.25 |
Well Sense Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $371.54 | Professional | None | $275.42 | $309.03 | $371.54 |
8 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 $186.21 Median $208.93 Typical High $524.81 | Professional | 52 · Reduced service | $186.21 | $208.93 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $213.80 | Professional | 53 · Discontinued | $74.13 | $83.18 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $316.23 Typical High $794.33 | Professional | 54 · Surgery only | $275.42 | $316.23 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $158.49 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $104.71 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $295.12 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $257.04 | $295.12 | $741.31 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $588.84 Typical High $2,041.74 | Professional | 54 · Surgery only | $489.78 | $588.84 | $2,041.74 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $263.03 |
Where Massachusetts sits
The same service costs 5.3 times more in Colorado than in Florida. 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 $4,377FL $831
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.