How much rates vary
Facilitymedian $1,288 · 10th to 90th $174 to $5,129Professionalmedian $257 · 10th to 90th $141 to $1,738
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $295.12 | Professional | None | $125.89 | $125.89 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $436.52 Median $1,995.26 Typical High $5,623.41 | Facility | None | $436.52 | $1,995.26 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $169.82 Median $416.87 Typical High $1,737.80 | Professional | None | $169.82 | $416.87 | $1,737.80 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,235.94 | Facility | None | $588.84 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $512.86 | Professional | None | $204.17 | $223.87 | $512.86 |
Fallon Health Setting Facility Modifier None Typical Low $154.88 Median $199.53 Typical High $3,311.31 | Facility | None | $154.88 | $199.53 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $234.42 | Professional | None | $162.18 | $190.55 | $234.42 |
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 $165.96 Median $309.03 Typical High $660.69 | Professional | None | $165.96 | $309.03 | $660.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $436.52 Median $1,995.26 Typical High $5,623.41 | Facility | None | $436.52 | $1,995.26 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $169.82 Median $416.87 Typical High $1,737.80 | Professional | None | $169.82 | $416.87 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $660.69 | Professional | None | $177.83 | $251.19 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $1,047.13 | Facility | None | $131.83 | $234.42 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | None | $120.23 | $120.23 | $144.54 |
5 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 $63.10 Median $63.10 Typical High $234.42 | Professional | 52 · Reduced service | $63.10 | $63.10 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $93.33 | Professional | 53 · Discontinued | $25.12 | $25.12 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $354.81 | Professional | 54 · Surgery only | $93.33 | $93.33 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $70.79 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $46.77 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $46.77 |
Where Massachusetts sits
The same service costs 13.0 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 $6,260MT $480
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.