How much rates vary
Facilitymedian $1,202 · 10th to 90th $407 to $3,631Professionalmedian $1,660 · 10th to 90th $933 to $7,079
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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,202.26 | Professional | None | $741.31 | $741.31 | $1,202.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $812.83 Typical High $3,630.78 | Facility | None | $316.23 | $812.83 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $933.25 Median $2,511.89 Typical High $7,079.46 | Professional | None | $933.25 | $2,511.89 | $7,079.46 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,698.24 | $2,290.87 |
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 $1,621.81 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,621.81 | $2,884.03 |
Fallon Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,318.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,318.26 | $1,584.89 |
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 $1,174.90 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,174.90 | $2,137.96 | $3,235.94 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $812.83 Typical High $3,630.78 | Facility | None | $316.23 | $812.83 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $933.25 Median $2,511.89 Typical High $7,079.46 | Professional | None | $933.25 | $2,511.89 | $7,079.46 |
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 $1,318.26 Median $1,778.28 Typical High $4,677.35 | Professional | None | $1,318.26 | $1,778.28 | $4,677.35 |
Well Sense Setting Facility Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,513.56 | Facility | None | $758.58 | $1,000.00 | $1,513.56 |
Well Sense Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | None | $831.76 | $831.76 | $1,000.00 |
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 $371.54 Median $371.54 Typical High $602.56 | Professional | 52 · Reduced service | $371.54 | $371.54 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $239.88 | Professional | 53 · Discontinued | $147.91 | $147.91 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $912.01 | Professional | 54 · Surgery only | $549.54 | $549.54 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $181.97 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $120.23 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $851.14 |
Where Massachusetts sits
The same service costs 7.5 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 $13,030MD $1,737
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.