How much rates vary
Facilitymedian $1,175 · 10th to 90th $324 to $4,074Professionalmedian $427 · 10th to 90th $288 to $2,512
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 $288.40 Median $288.40 Typical High $812.83 | Professional | None | $288.40 | $288.40 | $812.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $1,318.26 Typical High $4,073.80 | Facility | None | $371.54 | $1,318.26 | $4,073.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $281.84 Median $645.65 Typical High $2,511.89 | Professional | None | $281.84 | $645.65 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,258.93 Typical High $1,819.70 | Facility | None | $446.68 | $1,258.93 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $724.44 | Professional | None | $389.05 | $389.05 | $724.44 |
Fallon Health Setting Facility Modifier None Typical Low $288.40 Median $380.19 Typical High $3,311.31 | Facility | None | $288.40 | $380.19 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $436.52 | Professional | None | $323.59 | $371.54 | $436.52 |
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 $309.03 Median $575.44 Typical High $912.01 | Professional | None | $309.03 | $575.44 | $912.01 |
Health New England Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $1,318.26 Typical High $4,073.80 | Facility | None | $371.54 | $1,318.26 | $4,073.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $281.84 Median $645.65 Typical High $2,511.89 | Professional | None | $281.84 | $645.65 | $2,511.89 |
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 $295.12 Median $416.87 Typical High $1,230.27 | Professional | None | $295.12 | $416.87 | $1,230.27 |
Well Sense Setting Facility Modifier None Typical Low $223.87 Median $398.11 Typical High $676.08 | Facility | None | $223.87 | $398.11 | $676.08 |
Well Sense Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
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 $144.54 Median $144.54 Typical High $407.38 | Professional | 52 · Reduced service | $144.54 | $144.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $162.18 | Professional | 53 · Discontinued | $57.54 | $57.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $616.60 | Professional | 54 · Surgery only | $218.78 | $218.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $123.03 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $81.28 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $575.44 |
Where Massachusetts sits
The same service costs 5.6 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 $4,847MT $873
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.