How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,000 to $8,318Professionalmedian $1,905 · 10th to 90th $1,202 to $8,511
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 $2,691.53 Median $3,162.28 Typical High $6,309.57 | Facility | None | $2,691.53 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,202.26 | $3,162.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $870.96 Median $3,890.45 Typical High $12,022.64 | Facility | None | $870.96 | $3,890.45 | $12,022.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,202.26 Median $2,951.21 Typical High $8,511.38 | Professional | None | $1,202.26 | $2,951.21 | $8,511.38 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,318.26 Median $7,762.47 Typical High $7,762.47 | Professional | None | $1,318.26 | $7,762.47 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $7,079.46 | Facility | None | $1,380.38 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,698.24 | $1,698.24 | $3,162.28 |
Fallon Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $3,311.31 | Facility | None | $1,288.25 | $1,659.59 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,698.24 | $1,949.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $13,182.57 | Facility | None | $891.25 | $3,890.45 | $13,182.57 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $3,981.07 | Professional | None | $1,445.44 | $2,630.27 | $3,981.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $870.96 Median $3,890.45 Typical High $12,022.64 | Facility | None | $870.96 | $3,890.45 | $12,022.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,202.26 Median $2,951.21 Typical High $8,511.38 | Professional | None | $1,202.26 | $2,951.21 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $5,495.41 | Professional | None | $1,230.27 | $1,778.28 | $5,495.41 |
Well Sense Setting Facility Modifier None Typical Low $977.24 Median $1,548.82 Typical High $2,398.83 | Facility | None | $977.24 | $1,548.82 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
7 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 $602.56 Median $602.56 Typical High $1,584.89 | Professional | 52 · Reduced service | $602.56 | $602.56 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $645.65 | Professional | 53 · Discontinued | $239.88 | $239.88 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $2,398.83 | Professional | 54 · Surgery only | $912.01 | $912.01 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $478.63 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $2,238.72 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $363.08 Typical High $489.78 | Professional | 80 · Assistant surgeon | $213.80 | $363.08 | $489.78 |
Where Massachusetts sits
The same service costs 5.5 times more in Colorado than in West Virginia. 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 $14,842WV $2,709
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.