How much rates vary
Facilitymedian $1,000 · 10th to 90th $288 to $3,890Professionalmedian $562 · 10th to 90th $302 to $1,259
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 $1,023.29 Median $2,818.38 Typical High $4,677.35 | Facility | None | $1,023.29 | $2,818.38 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $776.25 | Professional | None | $251.19 | $407.38 | $776.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $512.86 Median $1,380.38 Typical High $4,168.69 | Facility | None | $512.86 | $1,380.38 | $4,168.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $316.23 Median $676.08 Typical High $2,951.21 | Professional | None | $316.23 | $676.08 | $2,951.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $288.40 Median $346.74 Typical High $660.69 | Facility | None | $288.40 | $346.74 | $660.69 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $812.83 | Professional | None | $288.40 | $467.74 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,162.28 | Facility | None | $588.84 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $1,023.29 | Professional | None | $354.81 | $549.54 | $1,023.29 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $3,311.31 | Facility | None | $177.83 | $346.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $691.83 | Professional | None | $524.81 | $602.56 | $691.83 |
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 $331.13 Median $660.69 Typical High $1,174.90 | Professional | None | $331.13 | $660.69 | $1,174.90 |
Mass General Brigham Setting Facility Modifier None Typical Low $512.86 Median $1,380.38 Typical High $4,168.69 | Facility | None | $512.86 | $1,380.38 | $4,168.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $316.23 Median $676.08 Typical High $2,951.21 | Professional | None | $316.23 | $676.08 | $2,951.21 |
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 $562.34 Typical High $1,202.26 | Professional | None | $331.13 | $562.34 | $1,202.26 |
Well Sense Setting Facility Modifier None Typical Low $239.88 Median $407.38 Typical High $1,096.48 | Facility | None | $239.88 | $407.38 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $346.74 | Professional | None | $194.98 | $263.03 | $346.74 |
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 $123.03 Median $199.53 Typical High $389.05 | Professional | 52 · Reduced service | $123.03 | $199.53 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $81.28 Typical High $154.88 | Professional | 53 · Discontinued | $50.12 | $81.28 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $302.00 Typical High $575.44 | Professional | 54 · Surgery only | $186.21 | $302.00 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $60.26 Typical High $114.82 | Professional | 55 · Aftercare only | $37.15 | $60.26 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $40.74 Typical High $77.62 | Professional | 56 · Pre-op care only | $25.12 | $40.74 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $281.84 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $173.78 | $281.84 | $537.03 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $181.97 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $123.03 | $181.97 | $245.47 |
Where Massachusetts sits
The same service costs 6.3 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 $6,296MT $1,002
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.