How much rates vary
Facilitymedian $1,072 · 10th to 90th $145 to $4,266Professionalmedian $316 · 10th to 90th $162 to $1,778
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $478.63 | Professional | None | $213.80 | $213.80 | $478.63 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $1,698.24 Typical High $5,623.41 | Facility | None | $371.54 | $1,698.24 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $208.93 Median $588.84 Typical High $1,778.28 | Professional | None | $208.93 | $588.84 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,187.76 Typical High $3,311.31 | Facility | None | $446.68 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $707.95 | Professional | None | $288.40 | $288.40 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $123.03 Median $251.19 Typical High $1,412.54 | Facility | None | $123.03 | $251.19 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $316.23 | Professional | None | $120.23 | $213.80 | $316.23 |
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 $234.42 Median $426.58 Typical High $741.31 | Professional | None | $234.42 | $426.58 | $741.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $1,698.24 Typical High $5,623.41 | Facility | None | $371.54 | $1,698.24 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $208.93 Median $588.84 Typical High $1,778.28 | Professional | None | $208.93 | $588.84 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,332.54 | Facility | None | $1,047.13 | $2,344.23 | $9,332.54 |
United Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $870.96 | Professional | None | $234.42 | $323.59 | $870.96 |
Well Sense Setting Facility Modifier None Typical Low $169.82 Median $269.15 Typical High $1,174.90 | Facility | None | $169.82 | $269.15 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | None | $165.96 | $165.96 | $199.53 |
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 $107.15 Median $107.15 Typical High $338.84 | Professional | 52 · Reduced service | $107.15 | $107.15 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $134.90 | Professional | 53 · Discontinued | $42.66 | $42.66 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $512.86 | Professional | 54 · Surgery only | $158.49 | $158.49 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $102.33 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $67.61 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $478.63 |
Where Massachusetts sits
The same service costs 9.6 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 $6,197MT $647
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.