How much rates vary
Facilitymedian $741 · 10th to 90th $324 to $3,715Professionalmedian $708 · 10th to 90th $407 to $4,074
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 $2,187.76 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $1,318.26 | Professional | None | $426.58 | $457.09 | $1,318.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $416.87 Median $1,698.24 Typical High $5,011.87 | Facility | None | $416.87 | $1,698.24 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $426.58 Median $1,047.13 Typical High $4,073.80 | Professional | None | $426.58 | $1,047.13 | $4,073.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $1,023.29 | Facility | None | $446.68 | $537.03 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,398.83 | Facility | None | $446.68 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $1,412.54 | Professional | None | $588.84 | $630.96 | $1,412.54 |
Fallon Health Setting Facility Modifier None Typical Low $257.04 Median $489.78 Typical High $1,412.54 | Facility | None | $257.04 | $489.78 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $537.03 Typical High $776.25 | Professional | None | $302.00 | $537.03 | $776.25 |
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 $478.63 Median $933.25 Typical High $1,548.82 | Professional | None | $478.63 | $933.25 | $1,548.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $416.87 Median $1,698.24 Typical High $5,011.87 | Facility | None | $416.87 | $1,698.24 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $426.58 Median $1,047.13 Typical High $4,073.80 | Professional | None | $426.58 | $1,047.13 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,778.28 | Professional | None | $478.63 | $707.95 | $1,778.28 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $851.14 | Facility | None | $346.74 | $501.19 | $851.14 |
Well Sense Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $426.58 | Professional | None | $331.13 | $354.81 | $426.58 |
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 $213.80 Median $229.09 Typical High $660.69 | Professional | 52 · Reduced service | $213.80 | $229.09 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $269.15 | Professional | 53 · Discontinued | $87.10 | $91.20 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $1,000.00 | Professional | 54 · Surgery only | $323.59 | $346.74 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $199.53 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $45.71 Typical High $131.83 | Professional | 56 · Pre-op care only | $42.66 | $45.71 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $933.25 |
Where Massachusetts sits
The same service costs 4.8 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 $6,549ND $1,369
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.