How much rates vary
Facilitymedian $661 · 10th to 90th $331 to $3,548Professionalmedian $832 · 10th to 90th $407 to $3,311
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 $2,691.53 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $676.08 | Professional | None | $407.38 | $407.38 | $676.08 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $776.25 Typical High $3,548.13 | Facility | None | $331.13 | $776.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $436.52 Median $1,096.48 Typical High $3,311.31 | Professional | None | $436.52 | $1,096.48 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,348.96 | Professional | None | $676.08 | $676.08 | $1,348.96 |
Fallon Health Setting Facility Modifier None Typical Low $457.09 Median $562.34 Typical High $3,311.31 | Facility | None | $457.09 | $562.34 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $676.08 | Professional | None | $478.63 | $562.34 | $676.08 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $501.19 Median $977.24 Typical High $1,445.44 | Professional | None | $501.19 | $977.24 | $1,445.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $776.25 Typical High $3,548.13 | Facility | None | $331.13 | $776.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $436.52 Median $1,096.48 Typical High $3,311.31 | Professional | None | $436.52 | $1,096.48 | $3,311.31 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,000.00 Typical High $2,041.74 | Professional | None | $602.56 | $1,000.00 | $2,041.74 |
Well Sense Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $660.69 | Facility | None | $323.59 | $446.68 | $660.69 |
Well Sense Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | None | $478.63 | $478.63 | $575.44 |
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 $204.17 Median $204.17 Typical High $338.84 | Professional | 52 · Reduced service | $204.17 | $204.17 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $138.04 | Professional | 53 · Discontinued | $83.18 | $83.18 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $512.86 | Professional | 54 · Surgery only | $309.03 | $309.03 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $102.33 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $67.61 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $67.61 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $275.42 | $275.42 |
Where Massachusetts sits
The same service costs 13.6 times more in Colorado than in Maryland. 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 $15,162MD $1,112
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.