How much rates vary
Facilitymedian $871 · 10th to 90th $219 to $3,802Professionalmedian $389 · 10th to 90th $182 to $4,467
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 $2,570.40 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,570.40 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $933.25 | Professional | None | $162.18 | $162.18 | $933.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $537.03 Median $977.24 Typical High $3,548.13 | Facility | None | $537.03 | $977.24 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $213.80 Median $537.03 Typical High $4,466.84 | Professional | None | $213.80 | $537.03 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,122.02 Typical High $1,659.59 | Facility | None | $446.68 | $1,122.02 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $691.83 | Professional | None | $316.23 | $316.23 | $691.83 |
Fallon Health Setting Facility Modifier None Typical Low $190.55 Median $251.19 Typical High $3,311.31 | Facility | None | $190.55 | $251.19 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $295.12 | Professional | None | $204.17 | $239.88 | $295.12 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $5,128.61 | Facility | None | $549.54 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $208.93 Median $416.87 Typical High $676.08 | Professional | None | $208.93 | $416.87 | $676.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $537.03 Median $977.24 Typical High $3,548.13 | Facility | None | $537.03 | $977.24 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $213.80 Median $537.03 Typical High $4,466.84 | Professional | None | $213.80 | $537.03 | $4,466.84 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,165.95 | Facility | None | $575.44 | $1,380.38 | $6,165.95 |
United Setting Professional Modifier None Typical Low $245.47 Median $407.38 Typical High $724.44 | Professional | None | $245.47 | $407.38 | $724.44 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $1,122.02 | Facility | None | $162.18 | $288.40 | $1,122.02 |
Well Sense Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | None | $239.88 | $239.88 | $288.40 |
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 $81.28 Median $81.28 Typical High $467.74 | Professional | 52 · Reduced service | $81.28 | $81.28 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $186.21 | Professional | 53 · Discontinued | $32.36 | $32.36 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $691.83 | Professional | 54 · Surgery only | $120.23 | $120.23 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $138.04 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $93.33 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $93.33 |
Where Massachusetts sits
The same service costs 7.6 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 $4,681MT $618
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.