How much rates vary
Facilitymedian $676 · 10th to 90th $68 to $3,890Professionalmedian $141 · 10th to 90th $72 to $1,514
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 $100.00 Median $100.00 Typical High $173.78 | Professional | None | $100.00 | $100.00 | $173.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,380.38 Typical High $4,168.69 | Facility | None | $323.59 | $1,380.38 | $4,168.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $100.00 Median $239.88 Typical High $1,513.56 | Professional | None | $100.00 | $239.88 | $1,513.56 |
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 $128.82 Median $128.82 Typical High $323.59 | Professional | None | $128.82 | $128.82 | $323.59 |
Fallon Health Setting Facility Modifier None Typical Low $54.95 Median $109.65 Typical High $1,412.54 | Facility | None | $54.95 | $109.65 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $53.70 Median $95.50 Typical High $138.04 | Professional | None | $53.70 | $95.50 | $138.04 |
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 $104.71 Median $194.98 Typical High $354.81 | Professional | None | $104.71 | $194.98 | $354.81 |
Health New England Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,162.28 | Facility | None | $3,019.95 | $3,019.95 | $3,162.28 |
Health New England Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,380.38 Typical High $4,168.69 | Facility | None | $323.59 | $1,380.38 | $4,168.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $100.00 Median $239.88 Typical High $1,513.56 | Professional | None | $100.00 | $239.88 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,413.10 | Facility | None | $1,047.13 | $2,344.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $426.58 | Professional | None | $109.65 | $151.36 | $426.58 |
Well Sense Setting Facility Modifier None Typical Low $77.62 Median $138.04 Typical High $676.08 | Facility | None | $77.62 | $138.04 | $676.08 |
Well Sense Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | None | $75.86 | $75.86 | $91.20 |
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 $50.12 Median $50.12 Typical High $154.88 | Professional | 52 · Reduced service | $50.12 | $50.12 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $61.66 | Professional | 53 · Discontinued | $19.95 | $19.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $229.09 | Professional | 54 · Surgery only | $74.13 | $74.13 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $45.71 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $30.90 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $30.90 |
Where Massachusetts sits
The same service costs 15.6 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 $4,608MT $296
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.