How much rates vary
Facilitymedian $851 · 10th to 90th $174 to $5,248Professionalmedian $741 · 10th to 90th $200 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 $1,230.27 Median $2,818.38 Typical High $5,248.07 | Facility | None | $1,230.27 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $416.87 Typical High $630.96 | Professional | None | $123.03 | $416.87 | $630.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $436.52 Median $1,949.84 Typical High $5,495.41 | Facility | None | $436.52 | $1,949.84 | $5,495.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $213.80 Median $812.83 Typical High $5,248.07 | Professional | None | $213.80 | $812.83 | $5,248.07 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $407.38 | Facility | None | $173.78 | $173.78 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $741.31 Typical High $912.01 | Facility | None | $478.63 | $741.31 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $776.25 Typical High $1,479.11 | Professional | None | $275.42 | $776.25 | $1,479.11 |
Fallon Health Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $3,311.31 | Facility | None | $173.78 | $229.09 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,047.13 | Professional | None | $724.44 | $851.14 | $1,047.13 |
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 $199.53 Median $707.95 Typical High $1,819.70 | Professional | None | $199.53 | $707.95 | $1,819.70 |
Mass General Brigham Setting Facility Modifier None Typical Low $436.52 Median $1,949.84 Typical High $5,495.41 | Facility | None | $436.52 | $1,949.84 | $5,495.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $213.80 Median $812.83 Typical High $5,248.07 | Professional | None | $213.80 | $812.83 | $5,248.07 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $245.47 Median $794.33 Typical High $2,089.30 | Professional | None | $245.47 | $794.33 | $2,089.30 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $512.86 Typical High $1,148.15 | Facility | None | $162.18 | $512.86 | $1,148.15 |
Well Sense Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $467.74 | Professional | None | $144.54 | $173.78 | $467.74 |
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 $61.66 Median $208.93 Typical High $316.23 | Professional | 52 · Reduced service | $61.66 | $208.93 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $83.18 Typical High $125.89 | Professional | 53 · Discontinued | $24.55 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $316.23 Typical High $467.74 | Professional | 54 · Surgery only | $93.33 | $316.23 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $63.10 Typical High $95.50 | Professional | 55 · Aftercare only | $18.62 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $41.69 Typical High $63.10 | Professional | 56 · Pre-op care only | $12.30 | $41.69 | $63.10 |
Where Massachusetts sits
The same service costs 6.9 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 $7,377MT $1,063
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.