How much rates vary
Facilitymedian $1,122 · 10th to 90th $166 to $4,571Professionalmedian $240 · 10th to 90th $155 to $1,023
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 $1,548.82 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,548.82 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | None | $154.88 | $154.88 | $169.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $1,318.26 Typical High $5,128.61 | Facility | None | $331.13 | $1,318.26 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $1,023.29 | Professional | None | $165.96 | $354.81 | $1,023.29 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $2,454.71 | Professional | None | $537.03 | $537.03 | $2,454.71 |
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 $239.88 Median $239.88 Typical High $389.05 | Professional | None | $239.88 | $239.88 | $389.05 |
Fallon Health Setting Facility Modifier None Typical Low $151.36 Median $186.21 Typical High $3,311.31 | Facility | None | $151.36 | $186.21 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $257.04 | Professional | None | $165.96 | $194.98 | $257.04 |
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 $162.18 Median $309.03 Typical High $446.68 | Professional | None | $162.18 | $309.03 | $446.68 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $1,318.26 Typical High $5,128.61 | Facility | None | $331.13 | $1,318.26 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $1,023.29 | Professional | None | $165.96 | $354.81 | $1,023.29 |
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 $165.96 Median $234.42 Typical High $588.84 | Professional | None | $165.96 | $234.42 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $112.20 Median $169.82 Typical High $1,122.02 | Facility | None | $112.20 | $169.82 | $1,122.02 |
Well Sense Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
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 $77.62 Median $77.62 Typical High $81.28 | Professional | 52 · Reduced service | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | 53 · Discontinued | $31.62 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $120.23 | Professional | 54 · Surgery only | $117.49 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.99 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $16.22 |
Where Massachusetts sits
The same service costs 11.1 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 $5,221MT $469
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.