How much rates vary
Facilitymedian $1,023 · 10th to 90th $195 to $5,623Professionalmedian $708 · 10th to 90th $214 to $2,884
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 $162.18 Median $363.08 Typical High $501.19 | Professional | None | $162.18 | $363.08 | $501.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $2,818.38 Typical High $7,762.47 | Facility | None | $446.68 | $2,818.38 | $7,762.47 |
AllWays Health Partners Setting Professional Modifier None Typical Low $239.88 Median $812.83 Typical High $6,456.54 | Professional | None | $239.88 | $812.83 | $6,456.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $457.09 | Facility | None | $194.98 | $194.98 | $457.09 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $194.98 Median $851.14 Typical High $1,819.70 | Professional | None | $194.98 | $851.14 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,715.35 Typical High $4,786.30 | Facility | None | $676.08 | $3,715.35 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $870.96 Typical High $2,137.96 | Professional | None | $239.88 | $870.96 | $2,137.96 |
Fallon Health Setting Facility Modifier None Typical Low $199.53 Median $257.04 Typical High $3,311.31 | Facility | None | $199.53 | $257.04 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,288.25 | $1,584.89 |
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 $218.78 Median $776.25 Typical High $2,454.71 | Professional | None | $218.78 | $776.25 | $2,454.71 |
Health New England Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,311.31 | Facility | None | $3,235.94 | $3,235.94 | $3,311.31 |
Health New England Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $2,818.38 Typical High $7,762.47 | Facility | None | $446.68 | $2,818.38 | $7,762.47 |
Mass General Brigham Setting Professional Modifier None Typical Low $239.88 Median $812.83 Typical High $6,456.54 | Professional | None | $239.88 | $812.83 | $6,456.54 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $11,481.54 | Facility | None | $851.14 | $2,818.38 | $11,481.54 |
United Setting Professional Modifier None Typical Low $257.04 Median $676.08 Typical High $2,398.83 | Professional | None | $257.04 | $676.08 | $2,398.83 |
Well Sense Setting Facility Modifier None Typical Low $169.82 Median $616.60 Typical High $1,621.81 | Facility | None | $169.82 | $616.60 | $1,621.81 |
Well Sense Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $407.38 | Professional | None | $158.49 | $190.55 | $407.38 |
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 $81.28 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $81.28 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $70.79 Typical High $72.44 | Professional | 53 · Discontinued | $32.36 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $120.23 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $23.99 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $35.48 Typical High $36.31 | Professional | 56 · Pre-op care only | $16.22 | $35.48 | $36.31 |
Where Massachusetts sits
The same service costs 11.1 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 $11,265MT $1,011
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.