How much rates vary
Facilitymedian $1,148 · 10th to 90th $490 to $4,571Professionalmedian $1,047 · 10th to 90th $617 to $4,571
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,659.59 | Professional | None | $537.03 | $537.03 | $1,659.59 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $1,479.11 Typical High $4,786.30 | Facility | None | $371.54 | $1,479.11 | $4,786.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $4,570.88 | Professional | None | $691.83 | $1,584.89 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,089.30 Typical High $3,162.28 | Facility | None | $446.68 | $2,089.30 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,698.24 | Professional | None | $870.96 | $870.96 | $1,698.24 |
Fallon Health Setting Facility Modifier None Typical Low $645.65 Median $891.25 Typical High $3,311.31 | Facility | None | $645.65 | $891.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,071.52 | Professional | None | $794.33 | $933.25 | $1,071.52 |
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 $741.31 Median $1,348.96 Typical High $2,041.74 | Professional | None | $741.31 | $1,348.96 | $2,041.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $1,479.11 Typical High $4,786.30 | Facility | None | $371.54 | $1,479.11 | $4,786.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $4,570.88 | Professional | None | $691.83 | $1,584.89 | $4,570.88 |
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 $691.83 Median $977.24 Typical High $2,754.23 | Professional | None | $691.83 | $977.24 | $2,754.23 |
Well Sense Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $1,148.15 | Facility | None | $446.68 | $741.31 | $1,148.15 |
Well Sense Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | None | $416.87 | $416.87 | $562.34 |
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 $269.15 Median $269.15 Typical High $831.76 | Professional | 52 · Reduced service | $269.15 | $269.15 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $331.13 | Professional | 53 · Discontinued | $107.15 | $107.15 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $1,258.93 | Professional | 54 · Surgery only | $407.38 | $407.38 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $251.19 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $165.96 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $1,174.90 |
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 $6,515DE $1,300
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.