How much rates vary
Facilitymedian $575 · 10th to 90th $219 to $3,548Professionalmedian $457 · 10th to 90th $214 to $1,413
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $549.54 | Professional | None | $141.25 | $213.80 | $549.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,630.78 | Facility | None | $446.68 | $1,096.48 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $234.42 Median $512.86 Typical High $2,344.23 | Professional | None | $234.42 | $512.86 | $2,344.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $208.93 Median $257.04 Typical High $478.63 | Facility | None | $208.93 | $257.04 | $478.63 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $660.69 | Professional | None | $208.93 | $371.54 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,445.44 | Facility | None | $588.84 | $1,000.00 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $794.33 | Professional | None | $323.59 | $501.19 | $794.33 |
Fallon Health Setting Facility Modifier None Typical Low $208.93 Median $275.42 Typical High $3,311.31 | Facility | None | $208.93 | $275.42 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $549.54 | Professional | None | $380.19 | $457.09 | $549.54 |
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 $229.09 Median $489.78 Typical High $954.99 | Professional | None | $229.09 | $489.78 | $954.99 |
Health New England Setting Facility Modifier None Typical Low $2,884.03 Median $6,025.60 Typical High $12,022.64 | Facility | None | $2,884.03 | $6,025.60 | $12,022.64 |
Health New England Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,630.78 | Facility | None | $446.68 | $1,096.48 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $234.42 Median $512.86 Typical High $2,344.23 | Professional | None | $234.42 | $512.86 | $2,344.23 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,456.54 | Facility | None | $575.44 | $1,380.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $1,071.52 | Professional | None | $281.84 | $478.63 | $1,071.52 |
Well Sense Setting Facility Modifier None Typical Low $181.97 Median $309.03 Typical High $489.78 | Facility | None | $181.97 | $309.03 | $489.78 |
Well Sense Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $223.87 | Professional | None | $151.36 | $177.83 | $223.87 |
7 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 $70.79 Median $107.15 Typical High $288.40 | Professional | 52 · Reduced service | $70.79 | $107.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $42.66 Typical High $114.82 | Professional | 53 · Discontinued | $28.18 | $42.66 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $436.52 | Professional | 54 · Surgery only | $104.71 | $162.18 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $87.10 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.38 Typical High $57.54 | Professional | 56 · Pre-op care only | $14.13 | $21.38 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $151.36 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $97.72 | $151.36 | $407.38 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $158.49 Typical High $208.93 | Professional | 53 · Discontinued | $120.23 | $158.49 | $208.93 |
Where Massachusetts sits
The same service costs 6.1 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 $4,737MT $778
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.