How much rates vary
Facilitymedian $2,692 · 10th to 90th $832 to $12,589Professionalmedian $1,622 · 10th to 90th $977 to $6,918
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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,884.03 | Professional | None | $933.25 | $933.25 | $2,884.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $14,454.40 | Facility | None | $707.95 | $3,890.45 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,023.29 Median $2,454.71 Typical High $6,918.31 | Professional | None | $1,023.29 | $2,454.71 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $11,481.54 Typical High $17,378.01 | Facility | None | $676.08 | $11,481.54 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,348.96 | $2,691.53 |
Fallon Health Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $3,311.31 | Facility | None | $933.25 | $1,288.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,348.96 | $1,548.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,122.02 | $2,089.30 | $3,162.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $14,454.40 | Facility | None | $707.95 | $3,890.45 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,023.29 Median $2,454.71 Typical High $6,918.31 | Professional | None | $1,023.29 | $2,454.71 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $19,054.61 | Facility | None | $1,071.52 | $3,890.45 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $4,466.84 | Professional | None | $1,148.15 | $1,584.89 | $4,466.84 |
Well Sense Setting Facility Modifier None Typical Low $831.76 Median $1,348.96 Typical High $6,760.83 | Facility | None | $831.76 | $1,348.96 | $6,760.83 |
Well Sense Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | None | $724.44 | $724.44 | $977.24 |
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 $467.74 Median $467.74 Typical High $1,445.44 | Professional | 52 · Reduced service | $467.74 | $467.74 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $575.44 | Professional | 53 · Discontinued | $186.21 | $186.21 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $2,137.96 | Professional | 54 · Surgery only | $691.83 | $691.83 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $426.58 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $288.40 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $1,995.26 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $288.40 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $288.40 | $389.05 |
Where Massachusetts sits
The same service costs 7.2 times more in Alaska than in Hawaii. 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 $19,657HI $2,734
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.