How much rates vary
Facilitymedian $794 · 10th to 90th $182 to $3,631Professionalmedian $275 · 10th to 90th $170 to $1,096
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | None | $169.82 | $169.82 | $190.55 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $1,096.48 Typical High $3,630.78 | Facility | None | $331.13 | $1,096.48 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $162.18 Median $398.11 Typical High $1,096.48 | Professional | None | $162.18 | $398.11 | $1,096.48 |
BCBS Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,288.25 | Professional | None | $645.65 | $645.65 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,380.38 Typical High $1,778.28 | Facility | None | $676.08 | $1,380.38 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $436.52 | Professional | None | $269.15 | $275.42 | $436.52 |
Fallon Health Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $3,311.31 | Facility | None | $165.96 | $213.80 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $288.40 | Professional | None | $181.97 | $213.80 | $288.40 |
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 $177.83 Median $338.84 Typical High $489.78 | Professional | None | $177.83 | $338.84 | $489.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $1,096.48 Typical High $3,630.78 | Facility | None | $331.13 | $1,096.48 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $162.18 Median $398.11 Typical High $1,096.48 | Professional | None | $162.18 | $398.11 | $1,096.48 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $660.69 | Professional | None | $181.97 | $257.04 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $562.34 | Facility | None | $134.90 | $186.21 | $562.34 |
Well Sense Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | None | $134.90 | $134.90 | $181.97 |
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 $83.18 Median $83.18 Typical High $89.13 | Professional | 52 · Reduced service | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | 53 · Discontinued | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 54 · Surgery only | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $26.92 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $17.78 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $17.78 |
Where Massachusetts sits
The same service costs 8.9 times more in Colorado than in West Virginia. 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 $4,215WV $472
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.