How much rates vary
Facilitymedian $661 · 10th to 90th $380 to $2,884Professionalmedian $724 · 10th to 90th $417 to $1,820
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 $1,000.00 Median $2,187.76 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $1,071.52 | Professional | None | $363.08 | $398.11 | $1,071.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $338.84 Median $1,000.00 Typical High $2,884.03 | Facility | None | $338.84 | $1,000.00 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $436.52 Median $851.14 Typical High $3,630.78 | Professional | None | $436.52 | $851.14 | $3,630.78 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $467.74 Median $575.44 Typical High $1,071.52 | Facility | None | $467.74 | $575.44 | $1,071.52 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $1,071.52 | Professional | None | $467.74 | $575.44 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $1,659.59 | Facility | None | $446.68 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,122.02 | Professional | None | $562.34 | $616.60 | $1,122.02 |
Fallon Health Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $3,311.31 | Facility | None | $457.09 | $588.84 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $851.14 | Professional | None | $630.96 | $741.31 | $851.14 |
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 $489.78 Median $954.99 Typical High $1,479.11 | Professional | None | $489.78 | $954.99 | $1,479.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $338.84 Median $1,000.00 Typical High $2,884.03 | Facility | None | $338.84 | $1,000.00 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $436.52 Median $851.14 Typical High $3,630.78 | Professional | None | $436.52 | $851.14 | $3,630.78 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $5,248.07 | Facility | None | $407.38 | $870.96 | $5,248.07 |
United Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $1,819.70 | Professional | None | $457.09 | $645.65 | $1,819.70 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $478.63 Typical High $724.44 | Facility | None | $346.74 | $478.63 | $724.44 |
Well Sense Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $371.54 | Professional | None | $275.42 | $295.12 | $371.54 |
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 $181.97 Median $199.53 Typical High $537.03 | Professional | 52 · Reduced service | $181.97 | $199.53 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $213.80 | Professional | 53 · Discontinued | $72.44 | $79.43 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $295.12 Typical High $812.83 | Professional | 54 · Surgery only | $275.42 | $295.12 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $162.18 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $39.81 Typical High $107.15 | Professional | 56 · Pre-op care only | $36.31 | $39.81 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $275.42 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $257.04 | $275.42 | $758.58 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $190.55 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $190.55 | $263.03 |
Where Massachusetts sits
The same service costs 4.7 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 $4,364DE $926
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.