How much rates vary
Facilitymedian $2,570 · 10th to 90th $708 to $8,710Professionalmedian $1,202 · 10th to 90th $741 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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,137.96 | Professional | None | $691.83 | $691.83 | $2,137.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $3,630.78 Typical High $10,232.93 | Facility | None | $707.95 | $3,630.78 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $812.83 Median $1,819.70 Typical High $6,760.83 | Professional | None | $812.83 | $1,819.70 | $6,760.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,659.59 | Professional | None | $758.58 | $758.58 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,165.95 Typical High $9,332.54 | Facility | None | $676.08 | $6,165.95 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,949.84 | Professional | None | $977.24 | $977.24 | $1,949.84 |
Fallon Health Setting Facility Modifier None Typical Low $741.31 Median $954.99 Typical High $3,311.31 | Facility | None | $741.31 | $954.99 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,148.15 | Professional | None | $851.14 | $977.24 | $1,148.15 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $812.83 Median $1,513.56 Typical High $2,290.87 | Professional | None | $812.83 | $1,513.56 | $2,290.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $3,630.78 Typical High $10,232.93 | Facility | None | $707.95 | $3,630.78 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $812.83 Median $1,819.70 Typical High $6,760.83 | Professional | None | $812.83 | $1,819.70 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $3,388.44 | Professional | None | $870.96 | $1,174.90 | $3,388.44 |
Well Sense Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $3,311.31 | Facility | None | $630.96 | $1,000.00 | $3,311.31 |
Well Sense Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
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 $346.74 Median $346.74 Typical High $1,071.52 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $426.58 | Professional | 53 · Discontinued | $141.25 | $141.25 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,584.89 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $323.59 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $213.80 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,479.11 |
Where Massachusetts sits
The same service costs 6.0 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 $14,230MT $2,377
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.