How much rates vary
Facilitymedian $2,399 · 10th to 90th $575 to $7,943Professionalmedian $871 · 10th to 90th $537 to $5,495
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 $1,778.28 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,513.56 | Professional | None | $501.19 | $501.19 | $1,513.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $575.44 Median $3,548.13 Typical High $10,232.93 | Facility | None | $575.44 | $3,548.13 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $588.84 Median $1,318.26 Typical High $5,495.41 | Professional | None | $588.84 | $1,318.26 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,677.35 Typical High $7,079.46 | Facility | None | $676.08 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,445.44 | Professional | None | $741.31 | $741.31 | $1,445.44 |
Fallon Health Setting Facility Modifier None Typical Low $575.44 Median $758.58 Typical High $3,311.31 | Facility | None | $575.44 | $758.58 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $870.96 | Professional | None | $645.65 | $758.58 | $870.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $630.96 Median $1,148.15 Typical High $1,737.80 | Professional | None | $630.96 | $1,148.15 | $1,737.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $575.44 Median $3,548.13 Typical High $10,232.93 | Facility | None | $575.44 | $3,548.13 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $588.84 Median $1,318.26 Typical High $5,495.41 | Professional | None | $588.84 | $1,318.26 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $2,454.71 | Professional | None | $616.60 | $831.76 | $2,454.71 |
Well Sense Setting Facility Modifier None Typical Low $457.09 Median $812.83 Typical High $2,398.83 | Facility | None | $457.09 | $812.83 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
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 $251.19 Median $251.19 Typical High $758.58 | Professional | 52 · Reduced service | $251.19 | $251.19 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $302.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $1,148.15 | Professional | 54 · Surgery only | $380.19 | $380.19 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $229.09 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $151.36 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $1,071.52 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $162.18 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $162.18 | $213.80 |
Where Massachusetts sits
The same service costs 7.9 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 $13,941MT $1,762
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.