How much rates vary
Facilitymedian $1,148 · 10th to 90th $490 to $4,677Professionalmedian $794 · 10th to 90th $479 to $6,761
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,348.96 | Professional | None | $457.09 | $457.09 | $1,348.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,380.38 Typical High $5,623.41 | Facility | None | $457.09 | $1,380.38 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $537.03 Median $1,202.26 Typical High $6,760.83 | Professional | None | $537.03 | $1,202.26 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,162.28 | Facility | None | $588.84 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,318.26 | Professional | None | $676.08 | $676.08 | $1,318.26 |
Fallon Health Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $3,311.31 | Facility | None | $512.86 | $676.08 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $794.33 | Professional | None | $588.84 | $676.08 | $794.33 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $562.34 Median $1,023.29 Typical High $1,548.82 | Professional | None | $562.34 | $1,023.29 | $1,548.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,380.38 Typical High $5,623.41 | Facility | None | $457.09 | $1,380.38 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $537.03 Median $1,202.26 Typical High $6,760.83 | Professional | None | $537.03 | $1,202.26 | $6,760.83 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $8,709.64 | Facility | None | $575.44 | $1,380.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $2,238.72 | Professional | None | $562.34 | $758.58 | $2,238.72 |
Well Sense Setting Facility Modifier None Typical Low $416.87 Median $562.34 Typical High $1,096.48 | Facility | None | $416.87 | $562.34 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $467.74 | Professional | None | $346.74 | $346.74 | $467.74 |
6 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 $229.09 Median $229.09 Typical High $676.08 | Professional | 52 · Reduced service | $229.09 | $229.09 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $275.42 | Professional | 53 · Discontinued | $91.20 | $91.20 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $1,023.29 | Professional | 54 · Surgery only | $338.84 | $338.84 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $204.17 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $134.90 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $954.99 |
Where Massachusetts sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $6,315DE $1,270
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.