How much rates vary
Facilitymedian $269 · 10th to 90th $115 to $3,388Professionalmedian $263 · 10th to 90th $135 to $1,380
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 $512.86 Median $2,818.38 Typical High $5,128.61 | Facility | None | $512.86 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $346.74 | Professional | None | $190.55 | $190.55 | $346.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $134.90 Median $724.44 Typical High $3,548.13 | Facility | None | $134.90 | $724.44 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $186.21 Median $489.78 Typical High $1,380.38 | Professional | None | $186.21 | $489.78 | $1,380.38 |
BCBS Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $416.87 | Professional | None | $181.97 | $257.04 | $416.87 |
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 $245.47 Median $245.47 Typical High $630.96 | Professional | None | $245.47 | $245.47 | $630.96 |
Fallon Health Setting Facility Modifier None Typical Low $102.33 Median $204.17 Typical High $457.09 | Facility | None | $102.33 | $204.17 | $457.09 |
Fallon Health Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $269.15 | Professional | None | $102.33 | $186.21 | $269.15 |
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 $204.17 Median $363.08 Typical High $562.34 | Professional | None | $204.17 | $363.08 | $562.34 |
Mass General Brigham Setting Facility Modifier None Typical Low $134.90 Median $724.44 Typical High $3,548.13 | Facility | None | $134.90 | $724.44 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $186.21 Median $489.78 Typical High $1,380.38 | Professional | None | $186.21 | $489.78 | $1,380.38 |
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 $204.17 Median $269.15 Typical High $831.76 | Professional | None | $204.17 | $269.15 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $281.84 | Facility | None | $134.90 | $186.21 | $281.84 |
Well Sense Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | None | $134.90 | $134.90 | $162.18 |
4 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 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $389.05 | Professional | 54 · Surgery only | $141.25 | $141.25 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $77.62 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $51.29 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $51.29 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $29.51 Median $50.12 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $29.51 | $50.12 | $67.61 |
Where Massachusetts sits
The same service costs 12.4 times more in Colorado than in Massachusetts. 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 $6,585MA $532
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.