How much rates vary
Facilitymedian $933 · 10th to 90th $437 to $3,311Professionalmedian $1,122 · 10th to 90th $676 to $4,786
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 $1,548.82 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,548.82 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,905.46 | Professional | None | $630.96 | $630.96 | $1,905.46 |
AllWays Health Partners Setting Facility Modifier None Typical Low $436.52 Median $1,023.29 Typical High $2,884.03 | Facility | None | $436.52 | $1,023.29 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $741.31 Median $1,698.24 Typical High $4,786.30 | Professional | None | $741.31 | $1,698.24 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,445.44 | Facility | None | $588.84 | $1,000.00 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,862.09 | Professional | None | $933.25 | $933.25 | $1,862.09 |
Fallon Health Setting Facility Modifier None Typical Low $707.95 Median $933.25 Typical High $3,311.31 | Facility | None | $707.95 | $933.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,096.48 | Professional | None | $812.83 | $933.25 | $1,096.48 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $2,187.76 | Professional | None | $794.33 | $1,445.44 | $2,187.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $436.52 Median $1,023.29 Typical High $2,884.03 | Facility | None | $436.52 | $1,023.29 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $741.31 Median $1,698.24 Typical High $4,786.30 | Professional | None | $741.31 | $1,698.24 | $4,786.30 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $5,370.32 | Facility | None | $407.38 | $870.96 | $5,370.32 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $3,090.30 | Professional | None | $776.25 | $1,071.52 | $3,090.30 |
Well Sense Setting Facility Modifier None Typical Low $457.09 Median $616.60 Typical High $1,047.13 | Facility | None | $457.09 | $616.60 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
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 $316.23 Median $316.23 Typical High $954.99 | Professional | 52 · Reduced service | $316.23 | $316.23 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $380.19 | Professional | 53 · Discontinued | $125.89 | $125.89 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $1,445.44 | Professional | 54 · Surgery only | $467.74 | $467.74 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $288.40 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $190.55 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $1,348.96 |
Where Massachusetts sits
The same service costs 3.6 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 $4,868DE $1,354
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.