How much rates vary
Facilitymedian $1,202 · 10th to 90th $316 to $4,898Professionalmedian $447 · 10th to 90th $275 to $3,981
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 $831.76 Median $2,238.72 Typical High $3,630.78 | Facility | None | $831.76 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $831.76 | Professional | None | $263.03 | $263.03 | $831.76 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $1,698.24 Typical High $5,623.41 | Facility | None | $371.54 | $1,698.24 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $302.00 Median $676.08 Typical High $3,981.07 | Professional | None | $302.00 | $676.08 | $3,981.07 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $660.69 | Professional | None | $288.40 | $288.40 | $660.69 |
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 $363.08 Median $363.08 Typical High $707.95 | Professional | None | $363.08 | $363.08 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $281.84 Median $371.54 Typical High $3,311.31 | Facility | None | $281.84 | $371.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $426.58 | Professional | None | $316.23 | $363.08 | $426.58 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $912.01 | Professional | None | $309.03 | $562.34 | $912.01 |
Health New England Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Health New England Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $1,698.24 Typical High $5,623.41 | Facility | None | $371.54 | $1,698.24 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $302.00 Median $676.08 Typical High $3,981.07 | Professional | None | $302.00 | $676.08 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $1,174.90 | Professional | None | $331.13 | $446.68 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $223.87 Median $398.11 Typical High $1,096.48 | Facility | None | $223.87 | $398.11 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $281.84 | Professional | None | $208.93 | $208.93 | $281.84 |
7 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 $131.83 Median $131.83 Typical High $416.87 | Professional | 52 · Reduced service | $131.83 | $131.83 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $165.96 | Professional | 53 · Discontinued | $52.48 | $52.48 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $630.96 | Professional | 54 · Surgery only | $199.53 | $199.53 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $125.89 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $83.18 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $588.84 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $275.42 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $229.09 | $275.42 | $501.19 |
Where Massachusetts sits
The same service costs 7.3 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 $6,269MT $863
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.