How much rates vary
Facilitymedian $776 · 10th to 90th $282 to $3,631Professionalmedian $468 · 10th to 90th $269 to $4,169
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 $281.84 Median $281.84 Typical High $1,513.56 | Professional | None | $281.84 | $281.84 | $1,513.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,311.31 | Facility | None | $354.81 | $1,096.48 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $281.84 Median $602.56 Typical High $4,168.69 | Professional | None | $281.84 | $602.56 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,445.44 | Facility | None | $446.68 | $977.24 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $660.69 | Professional | None | $354.81 | $354.81 | $660.69 |
Fallon Health Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $3,311.31 | Facility | None | $245.47 | $316.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $363.08 | Professional | None | $269.15 | $309.03 | $363.08 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $269.15 Median $512.86 Typical High $1,148.15 | Professional | None | $269.15 | $512.86 | $1,148.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,311.31 | Facility | None | $354.81 | $1,096.48 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $281.84 Median $602.56 Typical High $4,168.69 | Professional | None | $281.84 | $602.56 | $4,168.69 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,456.54 | Facility | None | $575.44 | $1,380.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $1,230.27 | Professional | None | $295.12 | $426.58 | $1,230.27 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $323.59 Typical High $489.78 | Facility | None | $208.93 | $323.59 | $489.78 |
Well Sense Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $426.58 | Professional | None | $194.98 | $263.03 | $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 $141.25 Median $141.25 Typical High $758.58 | Professional | 52 · Reduced service | $141.25 | $141.25 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $302.00 | Professional | 53 · Discontinued | $56.23 | $56.23 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $1,148.15 | Professional | 54 · Surgery only | $208.93 | $208.93 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $229.09 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $151.36 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $151.36 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $186.21 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $123.03 | $186.21 | $309.03 |
Where Massachusetts sits
The same service costs 6.0 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 $4,737MT $787
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.