How much rates vary
Facilitymedian $447 · 10th to 90th $102 to $3,890Professionalmedian $234 · 10th to 90th $138 to $1,905
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 $489.78 Median $2,187.76 Typical High $3,630.78 | Facility | None | $489.78 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $436.52 | Professional | None | $144.54 | $162.18 | $436.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $1,698.24 Typical High $5,623.41 | Facility | None | $331.13 | $1,698.24 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $1,905.46 | Professional | None | $144.54 | $338.84 | $1,905.46 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $323.59 | Facility | None | $141.25 | $169.82 | $323.59 |
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 $190.55 Median $218.78 Typical High $478.63 | Professional | None | $190.55 | $218.78 | $478.63 |
Fallon Health Setting Facility Modifier None Typical Low $81.28 Median $162.18 Typical High $1,412.54 | Facility | None | $81.28 | $162.18 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $269.15 | Professional | None | $104.71 | $186.21 | $269.15 |
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 $154.88 Median $302.00 Typical High $537.03 | Professional | None | $154.88 | $302.00 | $537.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $1,698.24 Typical High $5,623.41 | Facility | None | $331.13 | $1,698.24 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $1,905.46 | Professional | None | $144.54 | $338.84 | $1,905.46 |
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 $158.49 Median $229.09 Typical High $630.96 | Professional | None | $158.49 | $229.09 | $630.96 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $173.78 Typical High $676.08 | Facility | None | $117.49 | $173.78 | $676.08 |
Well Sense Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $144.54 | Professional | None | $109.65 | $120.23 | $144.54 |
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 $72.44 Median $81.28 Typical High $218.78 | Professional | 52 · Reduced service | $72.44 | $81.28 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $32.36 Typical High $89.13 | Professional | 53 · Discontinued | $29.51 | $32.36 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $120.23 Typical High $331.13 | Professional | 54 · Surgery only | $109.65 | $120.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $23.99 Typical High $66.07 | Professional | 55 · Aftercare only | $21.88 | $23.99 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.22 Typical High $43.65 | Professional | 56 · Pre-op care only | $14.45 | $16.22 | $43.65 |
Where Massachusetts sits
The same service costs 10.0 times more in Colorado than in North Dakota. 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 $4,594ND $460
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.