How much rates vary
Facilitymedian $2,188 · 10th to 90th $776 to $6,918Professionalmedian $1,514 · 10th to 90th $912 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 $1,949.84 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $2,570.40 | Professional | None | $831.76 | $831.76 | $2,570.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $630.96 Median $2,818.38 Typical High $9,549.93 | Facility | None | $630.96 | $2,818.38 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,047.13 Median $2,290.87 Typical High $6,760.83 | Professional | None | $1,047.13 | $2,290.87 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,677.35 Typical High $7,079.46 | Facility | None | $831.76 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,230.27 | $2,454.71 |
Fallon Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $3,311.31 | Facility | None | $1,000.00 | $1,288.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,348.96 | $1,548.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,995.26 | $3,019.95 |
Mass General Brigham Setting Facility Modifier None Typical Low $630.96 Median $2,818.38 Typical High $9,549.93 | Facility | None | $630.96 | $2,818.38 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,047.13 Median $2,290.87 Typical High $6,760.83 | Professional | None | $1,047.13 | $2,290.87 | $6,760.83 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $12,302.69 | Facility | None | $851.14 | $2,818.38 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $4,168.69 | Professional | None | $1,071.52 | $1,445.44 | $4,168.69 |
Well Sense Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $2,398.83 | Facility | None | $758.58 | $1,071.52 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
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 $416.87 Median $416.87 Typical High $1,288.25 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $512.86 | Professional | 53 · Discontinued | $165.96 | $165.96 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $1,905.46 | Professional | 54 · Surgery only | $616.60 | $616.60 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $380.19 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $257.04 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,778.28 |
Where Massachusetts sits
The same service costs 4.2 times more in Colorado than in Montana. 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 $12,508MT $2,994
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.