How much rates vary
Facilitymedian $617 · 10th to 90th $56 to $3,631Professionalmedian $120 · 10th to 90th $59 to $676
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $257.04 | Professional | None | $85.11 | $85.11 | $257.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $3,801.89 | Facility | None | $323.59 | $1,258.93 | $3,801.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $81.28 Median $208.93 Typical High $676.08 | Professional | None | $81.28 | $208.93 | $676.08 |
BCBS Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $295.12 | Professional | None | $162.18 | $213.80 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $1,905.46 | Facility | None | $446.68 | $1,318.26 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $275.42 | Professional | None | $107.15 | $107.15 | $275.42 |
Fallon Health Setting Facility Modifier None Typical Low $45.71 Median $93.33 Typical High $1,412.54 | Facility | None | $45.71 | $93.33 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $114.82 | Professional | None | $44.67 | $79.43 | $114.82 |
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 $85.11 Median $158.49 Typical High $316.23 | Professional | None | $85.11 | $158.49 | $316.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $3,801.89 | Facility | None | $323.59 | $1,258.93 | $3,801.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $81.28 Median $208.93 Typical High $676.08 | Professional | None | $81.28 | $208.93 | $676.08 |
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 $89.13 Median $125.89 Typical High $354.81 | Professional | None | $89.13 | $125.89 | $354.81 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $100.00 Typical High $676.08 | Facility | None | $63.10 | $100.00 | $676.08 |
Well Sense Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
6 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 $42.66 Median $42.66 Typical High $125.89 | Professional | 52 · Reduced service | $42.66 | $42.66 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $51.29 | Professional | 53 · Discontinued | $16.98 | $16.98 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $190.55 | Professional | 54 · Surgery only | $63.10 | $63.10 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $38.02 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $25.70 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $58.88 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $58.88 | $58.88 | $177.83 |
Where Massachusetts sits
The same service costs 18.4 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 $4,483MT $243
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.