How much rates vary
Facilitymedian $1,660 · 10th to 90th $575 to $6,166Professionalmedian $871 · 10th to 90th $513 to $4,074
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 $1,621.81 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,621.81 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,621.81 | Professional | None | $501.19 | $501.19 | $1,621.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $2,344.23 Typical High $6,606.93 | Facility | None | $724.44 | $2,344.23 | $6,606.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $575.44 Median $1,258.93 Typical High $4,073.80 | Professional | None | $575.44 | $1,258.93 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $3,162.28 | Facility | None | $741.31 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,380.38 | Professional | None | $691.83 | $691.83 | $1,380.38 |
Fallon Health Setting Facility Modifier None Typical Low $549.54 Median $691.83 Typical High $3,311.31 | Facility | None | $549.54 | $691.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $812.83 | Professional | None | $616.60 | $707.95 | $812.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,548.82 | Professional | None | $588.84 | $1,096.48 | $1,548.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $2,344.23 Typical High $6,606.93 | Facility | None | $724.44 | $2,344.23 | $6,606.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $575.44 Median $1,258.93 Typical High $4,073.80 | Professional | None | $575.44 | $1,258.93 | $4,073.80 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $2,344.23 | Professional | None | $616.60 | $831.76 | $2,344.23 |
Well Sense Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $812.83 | Facility | None | $398.11 | $549.54 | $812.83 |
Well Sense Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | None | $407.38 | $407.38 | $549.54 |
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 $251.19 Median $251.19 Typical High $812.83 | Professional | 52 · Reduced service | $251.19 | $251.19 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $323.59 | Professional | 53 · Discontinued | $100.00 | $100.00 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $1,230.27 | Professional | 54 · Surgery only | $380.19 | $380.19 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $245.47 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $162.18 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $1,148.15 |
Where Massachusetts sits
The same service costs 8.2 times more in Colorado than in Kentucky. 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 $11,961KY $1,456
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.