How much rates vary
Facilitymedian $832 · 10th to 90th $191 to $3,631Professionalmedian $275 · 10th to 90th $155 to $1,622
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 $134.90 Median $134.90 Typical High $512.86 | Professional | None | $134.90 | $134.90 | $512.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $436.52 Median $1,096.48 Typical High $3,630.78 | Facility | None | $436.52 | $1,096.48 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $177.83 Median $436.52 Typical High $1,621.81 | Professional | None | $177.83 | $436.52 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,122.02 Typical High $1,621.81 | Facility | None | $446.68 | $1,122.02 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $524.81 | Professional | None | $204.17 | $234.42 | $524.81 |
Fallon Health Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $3,311.31 | Facility | None | $169.82 | $223.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $263.03 | Professional | None | $177.83 | $208.93 | $263.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $676.08 | Professional | None | $181.97 | $338.84 | $676.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $436.52 Median $1,096.48 Typical High $3,630.78 | Facility | None | $436.52 | $1,096.48 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $177.83 Median $436.52 Typical High $1,621.81 | Professional | None | $177.83 | $436.52 | $1,621.81 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,606.93 | Facility | None | $575.44 | $1,380.38 | $6,606.93 |
United Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $676.08 | Professional | None | $194.98 | $263.03 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $134.90 Median $239.88 Typical High $524.81 | Facility | None | $134.90 | $239.88 | $524.81 |
Well Sense Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | None | $128.82 | $128.82 | $154.88 |
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 $67.61 Median $67.61 Typical High $257.04 | Professional | 52 · Reduced service | $67.61 | $67.61 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $102.33 | Professional | 53 · Discontinued | $26.92 | $26.92 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $380.19 | Professional | 54 · Surgery only | $102.33 | $102.33 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $75.86 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $51.29 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $51.29 |
Where Massachusetts sits
The same service costs 9.2 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 $4,822MT $526
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.