How much rates vary
Facilitymedian $676 · 10th to 90th $195 to $3,631Professionalmedian $537 · 10th to 90th $251 to $1,445
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 $338.84 Median $2,137.96 Typical High $3,388.44 | Facility | None | $338.84 | $2,137.96 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $416.87 Typical High $562.34 | Professional | None | $239.88 | $416.87 | $562.34 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $1,380.38 Typical High $4,168.69 | Facility | None | $331.13 | $1,380.38 | $4,168.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $537.03 Typical High $3,467.37 | Professional | None | $263.03 | $537.03 | $3,467.37 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $457.09 | Facility | None | $194.98 | $194.98 | $457.09 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $194.98 Median $549.54 Typical High $1,148.15 | Professional | None | $194.98 | $549.54 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,479.11 Typical High $1,819.70 | Facility | None | $630.96 | $1,479.11 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $575.44 Typical High $1,047.13 | Professional | None | $269.15 | $575.44 | $1,047.13 |
Fallon Health Setting Facility Modifier None Typical Low $194.98 Median $257.04 Typical High $3,311.31 | Facility | None | $194.98 | $257.04 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $812.83 | Professional | None | $602.56 | $707.95 | $812.83 |
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 $251.19 Median $549.54 Typical High $1,288.25 | Professional | None | $251.19 | $549.54 | $1,288.25 |
Health New England Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $5,011.87 | Facility | None | $1,000.00 | $2,238.72 | $5,011.87 |
Health New England Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $1,380.38 Typical High $4,168.69 | Facility | None | $331.13 | $1,380.38 | $4,168.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $537.03 Typical High $3,467.37 | Professional | None | $263.03 | $537.03 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,244.36 | Facility | None | $1,047.13 | $2,344.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $1,288.25 | Professional | None | $288.40 | $562.34 | $1,288.25 |
Well Sense Setting Facility Modifier None Typical Low $169.82 Median $371.54 Typical High $676.08 | Facility | None | $169.82 | $371.54 | $676.08 |
Well Sense Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $436.52 | Professional | None | $181.97 | $245.47 | $436.52 |
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 $120.23 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $120.23 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $72.44 Typical High $91.20 | Professional | 53 · Discontinued | $47.86 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $177.83 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $54.95 Typical High $67.61 | Professional | 55 · Aftercare only | $35.48 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $36.31 Typical High $45.71 | Professional | 56 · Pre-op care only | $23.99 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $251.19 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $165.96 | $251.19 | $316.23 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $83.18 Typical High $213.80 | Professional | 53 · Discontinued | $63.10 | $83.18 | $213.80 |
Where Massachusetts sits
The same service costs 4.6 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 $4,728MT $1,029
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.