How much rates vary
Facilitymedian $1,479 · 10th to 90th $282 to $5,623Professionalmedian $398 · 10th to 90th $240 to $4,169
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 $194.98 Median $194.98 Typical High $467.74 | Professional | None | $194.98 | $194.98 | $467.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $5,754.40 | Facility | None | $501.19 | $1,995.26 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $660.69 Typical High $4,168.69 | Professional | None | $263.03 | $660.69 | $4,168.69 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $537.03 | Professional | None | $245.47 | $323.59 | $537.03 |
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 $309.03 Median $354.81 Typical High $776.25 | Professional | None | $309.03 | $354.81 | $776.25 |
Fallon Health Setting Facility Modifier None Typical Low $251.19 Median $323.59 Typical High $3,311.31 | Facility | None | $251.19 | $323.59 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $380.19 | Professional | None | $263.03 | $309.03 | $380.19 |
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 $269.15 Median $501.19 Typical High $1,000.00 | Professional | None | $269.15 | $501.19 | $1,000.00 |
Health New England Setting Facility Modifier None Typical Low $3,162.28 Median $7,413.10 Typical High $18,620.87 | Facility | None | $3,162.28 | $7,413.10 | $18,620.87 |
Health New England Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $5,754.40 | Facility | None | $501.19 | $1,995.26 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $660.69 Typical High $4,168.69 | Professional | None | $263.03 | $660.69 | $4,168.69 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,772.37 | Facility | None | $851.14 | $2,818.38 | $9,772.37 |
United Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $1,000.00 | Professional | None | $288.40 | $398.11 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $1,047.13 | Facility | None | $204.17 | $363.08 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | None | $190.55 | $190.55 | $229.09 |
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 $97.72 Median $97.72 Typical High $371.54 | Professional | 52 · Reduced service | $97.72 | $97.72 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $147.91 | Professional | 53 · Discontinued | $38.90 | $38.90 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $562.34 | Professional | 54 · Surgery only | $147.91 | $147.91 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $112.20 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $74.13 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $74.13 |
Where Massachusetts sits
The same service costs 8.5 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 $6,537MT $769
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.