How much rates vary
Facilitymedian $525 · 10th to 90th $105 to $3,311Professionalmedian $219 · 10th to 90th $105 to $1,072
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 $389.05 Median $2,691.53 Typical High $3,715.35 | Facility | None | $389.05 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $269.15 | Professional | None | $104.71 | $144.54 | $269.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $3,981.07 | Facility | None | $363.08 | $851.14 | $3,981.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $109.65 Median $245.47 Typical High $1,071.52 | Professional | None | $109.65 | $245.47 | $1,071.52 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $97.72 Median $120.23 Typical High $223.87 | Facility | None | $97.72 | $120.23 | $223.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,348.96 | Professional | None | $602.56 | $602.56 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,445.44 Typical High $2,089.30 | Facility | None | $588.84 | $1,445.44 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $223.87 Typical High $380.19 | Professional | None | $91.20 | $223.87 | $380.19 |
Fallon Health Setting Facility Modifier None Typical Low $97.72 Median $128.82 Typical High $3,311.31 | Facility | None | $97.72 | $128.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $295.12 | Professional | None | $177.83 | $218.78 | $295.12 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $407.38 | Professional | None | $123.03 | $229.09 | $407.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $3,981.07 | Facility | None | $363.08 | $851.14 | $3,981.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $109.65 Median $245.47 Typical High $1,071.52 | Professional | None | $109.65 | $245.47 | $1,071.52 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $6,309.57 | Facility | None | $407.38 | $870.96 | $6,309.57 |
United Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $407.38 | Professional | None | $120.23 | $199.53 | $407.38 |
Well Sense Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $707.95 | Facility | None | $91.20 | $151.36 | $707.95 |
Well Sense Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $120.23 | Professional | None | $74.13 | $100.00 | $120.23 |
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 $52.48 Median $72.44 Typical High $134.90 | Professional | 52 · Reduced service | $52.48 | $72.44 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $28.84 Typical High $54.95 | Professional | 53 · Discontinued | $20.89 | $28.84 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $109.65 Typical High $204.17 | Professional | 54 · Surgery only | $77.62 | $109.65 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $21.88 Typical High $40.74 | Professional | 55 · Aftercare only | $15.49 | $21.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.45 Typical High $26.92 | Professional | 56 · Pre-op care only | $10.47 | $14.45 | $26.92 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $63.10 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $46.77 | $63.10 | $77.62 |
Where Massachusetts sits
The same service costs 10.9 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 $3,950MT $363
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.