How much rates vary
Facilitymedian $1,096 · 10th to 90th $427 to $4,266Professionalmedian $794 · 10th to 90th $427 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 $549.54 Median $2,691.53 Typical High $3,630.78 | Facility | None | $549.54 | $2,691.53 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $1,071.52 | Professional | None | $354.81 | $549.54 | $1,071.52 |
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 $436.52 Median $954.99 Typical High $4,365.16 | Professional | None | $436.52 | $954.99 | $4,365.16 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $426.58 Median $512.86 Typical High $977.24 | Facility | None | $426.58 | $512.86 | $977.24 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $1,174.90 | Professional | None | $426.58 | $691.83 | $1,174.90 |
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 $524.81 Median $776.25 Typical High $1,412.54 | Professional | None | $524.81 | $776.25 | $1,412.54 |
Fallon Health Setting Facility Modifier None Typical Low $416.87 Median $549.54 Typical High $3,311.31 | Facility | None | $416.87 | $549.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,023.29 | Professional | None | $758.58 | $891.25 | $1,023.29 |
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 $457.09 Median $933.25 Typical High $1,698.24 | Professional | None | $457.09 | $933.25 | $1,698.24 |
Health New England Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $3,311.31 | Facility | None | $1,621.81 | $2,398.83 | $3,311.31 |
Health New England Setting Professional Modifier None Typical Low $33.11 Median $295.12 Typical High $616.60 | Professional | None | $33.11 | $295.12 | $616.60 |
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 $436.52 Median $954.99 Typical High $4,365.16 | Professional | None | $436.52 | $954.99 | $4,365.16 |
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 $467.74 Median $776.25 Typical High $1,737.80 | Professional | None | $467.74 | $776.25 | $1,737.80 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $588.84 Typical High $1,096.48 | Facility | None | $346.74 | $588.84 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $467.74 | Professional | None | $269.15 | $363.08 | $467.74 |
10 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 $177.83 Median $275.42 Typical High $537.03 | Professional | 52 · Reduced service | $177.83 | $275.42 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $109.65 Typical High $218.78 | Professional | 53 · Discontinued | $70.79 | $109.65 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $407.38 Typical High $812.83 | Professional | 54 · Surgery only | $263.03 | $407.38 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $83.18 Typical High $162.18 | Professional | 55 · Aftercare only | $52.48 | $83.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $54.95 Typical High $107.15 | Professional | 56 · Pre-op care only | $35.48 | $54.95 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $380.19 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $245.47 | $380.19 | $758.58 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $234.42 Typical High $316.23 | Professional | 55 · Aftercare only | $138.04 | $234.42 | $316.23 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $109.65 Typical High $194.98 | Professional | 80 · Assistant surgeon | $109.65 | $109.65 | $194.98 |
BCBS Massachusetts Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $109.65 Typical High $213.80 | Professional | AS · PA/NP assist | $66.07 | $109.65 | $213.80 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $251.19 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $173.78 | $251.19 | $338.84 |
Where Massachusetts sits
The same service costs 4.3 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 $6,199MT $1,425
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.