How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,072 to $8,318Professionalmedian $2,042 · 10th to 90th $1,318 to $11,220
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 $3,388.44 Typical High $6,309.57 | Facility | None | $2,691.53 | $3,388.44 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,318.26 | $3,019.95 |
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 $1,318.26 Median $3,090.30 Typical High $11,220.18 | Professional | None | $1,318.26 | $3,090.30 | $11,220.18 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,348.96 | $2,951.21 |
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 $1,819.70 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,819.70 | $1,819.70 | $3,388.44 |
Fallon Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $3,548.13 | Facility | None | $1,318.26 | $1,698.24 | $3,548.13 |
Fallon Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,737.80 | $1,995.26 |
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 $1,479.11 Median $2,691.53 Typical High $4,265.80 | Professional | None | $1,479.11 | $2,691.53 | $4,265.80 |
Health New England Setting Facility Modifier None Typical Low $3,890.45 Median $6,918.31 Typical High $21,877.62 | Facility | None | $3,890.45 | $6,918.31 | $21,877.62 |
Health New England Setting Professional Modifier None Typical Low $257.04 Median $1,905.46 Typical High $2,630.27 | Professional | None | $257.04 | $1,905.46 | $2,630.27 |
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 $1,318.26 Median $3,090.30 Typical High $11,220.18 | Professional | None | $1,318.26 | $3,090.30 | $11,220.18 |
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 $1,380.38 Median $1,995.26 Typical High $5,888.44 | Professional | None | $1,380.38 | $1,995.26 | $5,888.44 |
Well Sense Setting Facility Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $2,398.83 | Facility | None | $1,047.13 | $1,905.46 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,230.27 | Professional | None | $912.01 | $912.01 | $1,230.27 |
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 $660.69 Median $660.69 Typical High $1,819.70 | Professional | 52 · Reduced service | $660.69 | $660.69 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $724.44 | Professional | 53 · Discontinued | $263.03 | $263.03 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $537.03 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $363.08 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $2,511.89 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,862.09 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,862.09 | $2,454.71 |
Where Massachusetts sits
The same service costs 4.7 times more in Colorado than in Kentucky. 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 $15,002KY $3,224
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.