How much rates vary
Facilitymedian $1,047 · 10th to 90th $363 to $4,266Professionalmedian $692 · 10th to 90th $372 to $1,622
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 $954.99 Median $2,691.53 Typical High $3,715.35 | Facility | None | $954.99 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $954.99 | Professional | None | $302.00 | $478.63 | $954.99 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $2,041.74 Typical High $5,623.41 | Facility | None | $457.09 | $2,041.74 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $398.11 Median $794.33 Typical High $3,715.35 | Professional | None | $398.11 | $794.33 | $3,715.35 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $354.81 Median $436.52 Typical High $812.83 | Facility | None | $354.81 | $436.52 | $812.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $1,000.00 | Professional | None | $354.81 | $588.84 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,187.76 Typical High $3,162.28 | Facility | None | $446.68 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,202.26 | Professional | None | $436.52 | $660.69 | $1,202.26 |
Fallon Health Setting Facility Modifier None Typical Low $354.81 Median $467.74 Typical High $3,311.31 | Facility | None | $354.81 | $467.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $870.96 | Professional | None | $645.65 | $741.31 | $870.96 |
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 $407.38 Median $794.33 Typical High $1,412.54 | Professional | None | $407.38 | $794.33 | $1,412.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $2,041.74 Typical High $5,623.41 | Facility | None | $457.09 | $2,041.74 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $398.11 Median $794.33 Typical High $3,715.35 | Professional | None | $398.11 | $794.33 | $3,715.35 |
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 $407.38 Median $660.69 Typical High $1,479.11 | Professional | None | $407.38 | $660.69 | $1,479.11 |
Well Sense Setting Facility Modifier None Typical Low $295.12 Median $501.19 Typical High $1,096.48 | Facility | None | $295.12 | $501.19 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $407.38 | Professional | None | $239.88 | $323.59 | $407.38 |
8 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 $151.36 Median $239.88 Typical High $478.63 | Professional | 52 · Reduced service | $151.36 | $239.88 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $95.50 Typical High $190.55 | Professional | 53 · Discontinued | $60.26 | $95.50 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $354.81 Typical High $724.44 | Professional | 54 · Surgery only | $229.09 | $354.81 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $70.79 Typical High $144.54 | Professional | 55 · Aftercare only | $45.71 | $70.79 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $47.86 Typical High $95.50 | Professional | 56 · Pre-op care only | $30.20 | $47.86 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $331.13 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $213.80 | $331.13 | $676.08 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $380.19 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $288.40 | $380.19 | $660.69 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $151.36 | $213.80 | $288.40 |
Where Massachusetts sits
The same service costs 5.3 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 $6,378MT $1,213
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.