How much rates vary
Facilitymedian $2,089 · 10th to 90th $794 to $7,079Professionalmedian $1,288 · 10th to 90th $741 to $7,079
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 $8,709.64 | Facility | None | $2,691.53 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $2,137.96 | Professional | None | $741.31 | $741.31 | $2,137.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $954.99 Median $3,090.30 Typical High $9,549.93 | Facility | None | $954.99 | $3,090.30 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $776.25 Median $1,905.46 Typical High $7,079.46 | Professional | None | $776.25 | $1,905.46 | $7,079.46 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $812.83 Median $1,380.38 Typical High $2,454.71 | Professional | None | $812.83 | $1,380.38 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,981.07 Typical High $5,754.40 | Facility | None | $1,318.26 | $3,981.07 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,071.52 | $2,089.30 |
Fallon Health Setting Facility Modifier None Typical Low $794.33 Median $1,047.13 Typical High $3,311.31 | Facility | None | $794.33 | $1,047.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,202.26 | Professional | None | $891.25 | $1,023.29 | $1,202.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $2,398.83 | Professional | None | $851.14 | $1,584.89 | $2,398.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $954.99 Median $3,090.30 Typical High $9,549.93 | Facility | None | $954.99 | $3,090.30 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $776.25 Median $1,905.46 Typical High $7,079.46 | Professional | None | $776.25 | $1,905.46 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $13,489.63 | Facility | None | $1,071.52 | $3,467.37 | $13,489.63 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $3,630.78 | Professional | None | $831.76 | $1,230.27 | $3,630.78 |
Well Sense Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $1,905.46 | Facility | None | $660.69 | $1,202.26 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $758.58 | Professional | None | $562.34 | $562.34 | $758.58 |
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 $371.54 Median $371.54 Typical High $1,071.52 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $426.58 | Professional | 53 · Discontinued | $147.91 | $147.91 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $1,621.81 | Professional | 54 · Surgery only | $549.54 | $549.54 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $323.59 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $213.80 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $1,513.56 |
Where Massachusetts sits
The same service costs 4.9 times more in Alaska 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
AK $10,315KY $2,095
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.