How much rates vary
Facilitymedian $1,023 · 10th to 90th $447 to $4,266Professionalmedian $871 · 10th to 90th $479 to $2,089
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 $1,148.15 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,148.15 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $1,148.15 | Professional | None | $371.54 | $549.54 | $1,148.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,778.28 Typical High $5,011.87 | Facility | None | $457.09 | $1,778.28 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $478.63 Median $1,023.29 Typical High $4,570.88 | Professional | None | $478.63 | $1,023.29 | $4,570.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $1,023.29 | Facility | None | $446.68 | $537.03 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $2,398.83 | Facility | None | $588.84 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,445.44 | Professional | None | $549.54 | $794.33 | $1,445.44 |
Fallon Health Setting Facility Modifier None Typical Low $436.52 Median $575.44 Typical High $3,311.31 | Facility | None | $436.52 | $575.44 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,071.52 | Professional | None | $794.33 | $912.01 | $1,071.52 |
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 $489.78 Median $954.99 Typical High $1,778.28 | Professional | None | $489.78 | $954.99 | $1,778.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,778.28 Typical High $5,011.87 | Facility | None | $457.09 | $1,778.28 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $478.63 Median $1,023.29 Typical High $4,570.88 | Professional | None | $478.63 | $1,023.29 | $4,570.88 |
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 $512.86 Median $794.33 Typical High $1,862.09 | Professional | None | $512.86 | $794.33 | $1,862.09 |
Well Sense Setting Facility Modifier None Typical Low $380.19 Median $588.84 Typical High $891.25 | Facility | None | $380.19 | $588.84 | $891.25 |
Well Sense Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $489.78 | Professional | None | $295.12 | $398.11 | $489.78 |
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 $186.21 Median $275.42 Typical High $575.44 | Professional | 52 · Reduced service | $186.21 | $275.42 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $109.65 Typical High $229.09 | Professional | 53 · Discontinued | $74.13 | $109.65 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $407.38 Typical High $870.96 | Professional | 54 · Surgery only | $275.42 | $407.38 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $81.28 Typical High $173.78 | Professional | 55 · Aftercare only | $56.23 | $81.28 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $54.95 Typical High $114.82 | Professional | 56 · Pre-op care only | $37.15 | $54.95 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $380.19 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $257.04 | $380.19 | $812.83 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $257.04 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $186.21 | $257.04 | $346.74 |
Where Massachusetts sits
The same service costs 4.4 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 $6,491MT $1,489
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.