How much rates vary
Facilitymedian $631 · 10th to 90th $251 to $4,571Professionalmedian $631 · 10th to 90th $363 to $6,310
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 $363.08 Median $446.68 Typical High $1,174.90 | Professional | None | $363.08 | $446.68 | $1,174.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $1,862.09 Typical High $5,754.40 | Facility | None | $371.54 | $1,862.09 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $346.74 Median $851.14 Typical High $6,309.57 | Professional | None | $346.74 | $851.14 | $6,309.57 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $776.25 | Facility | None | $338.84 | $407.38 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,467.37 Typical High $5,248.07 | Facility | None | $446.68 | $3,467.37 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,202.26 | Professional | None | $467.74 | $588.84 | $1,202.26 |
Fallon Health Setting Facility Modifier None Typical Low $194.98 Median $380.19 Typical High $1,412.54 | Facility | None | $194.98 | $380.19 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $724.44 | Professional | None | $281.84 | $501.19 | $724.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $371.54 Median $758.58 Typical High $1,445.44 | Professional | None | $371.54 | $758.58 | $1,445.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $1,862.09 Typical High $5,754.40 | Facility | None | $371.54 | $1,862.09 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $346.74 Median $851.14 Typical High $6,309.57 | Professional | None | $346.74 | $851.14 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $11,481.54 | Facility | None | $1,047.13 | $2,344.23 | $11,481.54 |
United Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $1,548.82 | Professional | None | $407.38 | $602.56 | $1,548.82 |
Well Sense Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $1,698.24 | Facility | None | $302.00 | $436.52 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $416.87 | Professional | None | $288.40 | $346.74 | $416.87 |
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 $181.97 Median $218.78 Typical High $575.44 | Professional | 52 · Reduced service | $181.97 | $218.78 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $89.13 Typical High $234.42 | Professional | 53 · Discontinued | $72.44 | $89.13 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $331.13 Typical High $870.96 | Professional | 54 · Surgery only | $269.15 | $331.13 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $66.07 Typical High $173.78 | Professional | 55 · Aftercare only | $53.70 | $66.07 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $44.67 Typical High $117.49 | Professional | 56 · Pre-op care only | $36.31 | $44.67 | $117.49 |
Where Massachusetts sits
The same service costs 6.3 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 $7,350MT $1,166
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.