How much rates vary
Facilitymedian $1,175 · 10th to 90th $437 to $6,166Professionalmedian $851 · 10th to 90th $457 to $4,467
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 $912.01 Median $2,818.38 Typical High $5,248.07 | Facility | None | $912.01 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $1,071.52 | Professional | None | $331.13 | $457.09 | $1,071.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $3,090.30 Typical High $9,549.93 | Facility | None | $645.65 | $3,090.30 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $457.09 Median $1,023.29 Typical High $4,466.84 | Professional | None | $457.09 | $1,023.29 | $4,466.84 |
BCBS Setting Facility Modifier None Typical Low $436.52 Median $524.81 Typical High $1,000.00 | Facility | None | $436.52 | $524.81 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,890.45 Typical High $5,754.40 | Facility | None | $831.76 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $1,445.44 | Professional | None | $501.19 | $676.08 | $1,445.44 |
Fallon Health Setting Facility Modifier None Typical Low $436.52 Median $562.34 Typical High $3,311.31 | Facility | None | $436.52 | $562.34 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,096.48 | Professional | None | $741.31 | $891.25 | $1,096.48 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $478.63 Median $933.25 Typical High $1,737.80 | Professional | None | $478.63 | $933.25 | $1,737.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $3,090.30 Typical High $9,549.93 | Facility | None | $645.65 | $3,090.30 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $457.09 Median $1,023.29 Typical High $4,466.84 | Professional | None | $457.09 | $1,023.29 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $13,489.63 | Facility | None | $1,071.52 | $3,467.37 | $13,489.63 |
United Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,819.70 | Professional | None | $537.03 | $794.33 | $1,819.70 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $549.54 Typical High $1,905.46 | Facility | None | $346.74 | $549.54 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $501.19 | Professional | None | $316.23 | $380.19 | $501.19 |
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 $165.96 Median $223.87 Typical High $616.60 | Professional | 52 · Reduced service | $165.96 | $223.87 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $91.20 Typical High $251.19 | Professional | 53 · Discontinued | $66.07 | $91.20 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $933.25 | Professional | 54 · Surgery only | $245.47 | $338.84 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $67.61 Typical High $186.21 | Professional | 55 · Aftercare only | $50.12 | $67.61 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $45.71 Typical High $125.89 | Professional | 56 · Pre-op care only | $33.11 | $45.71 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $870.96 |
Where Massachusetts sits
The same service costs 6.1 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 $9,157MT $1,508
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.