How much rates vary
Facilitymedian $2,692 · 10th to 90th $933 to $15,849Professionalmedian $1,778 · 10th to 90th $1,096 to $10,000
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 $3,467.37 Typical High $7,413.10 | Facility | None | $2,691.53 | $3,467.37 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $3,162.28 | Professional | None | $1,047.13 | $1,047.13 | $3,162.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $831.76 Median $4,677.35 Typical High $19,498.45 | Facility | None | $831.76 | $4,677.35 | $19,498.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,174.90 Median $2,691.53 Typical High $10,000.00 | Professional | None | $1,174.90 | $2,691.53 | $10,000.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,174.90 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $13,489.63 Typical High $20,417.38 | Facility | None | $831.76 | $13,489.63 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,479.11 | $2,951.21 |
Fallon Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $3,311.31 | Facility | None | $1,148.15 | $1,445.44 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,479.11 | $1,737.80 |
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 $1,258.93 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,258.93 | $2,290.87 | $3,467.37 |
Mass General Brigham Setting Facility Modifier None Typical Low $831.76 Median $4,677.35 Typical High $19,498.45 | Facility | None | $831.76 | $4,677.35 | $19,498.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,174.90 Median $2,691.53 Typical High $10,000.00 | Professional | None | $1,174.90 | $2,691.53 | $10,000.00 |
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 $1,230.27 Median $1,737.80 Typical High $5,128.61 | Professional | None | $1,230.27 | $1,737.80 | $5,128.61 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,737.80 | Facility | None | $851.14 | $1,174.90 | $1,737.80 |
Well Sense Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,096.48 | Professional | None | $812.83 | $812.83 | $1,096.48 |
8 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 $524.81 Median $524.81 Typical High $1,584.89 | Professional | 52 · Reduced service | $524.81 | $524.81 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $630.96 | Professional | 53 · Discontinued | $208.93 | $208.93 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $2,398.83 | Professional | 54 · Surgery only | $776.25 | $776.25 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $478.63 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $316.23 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $2,238.72 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $398.11 Typical High $524.81 | Professional | 55 · Aftercare only | $234.42 | $398.11 | $524.81 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,584.89 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $933.25 | $1,584.89 | $2,137.96 |
Where Massachusetts sits
The same service costs 10.4 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 $29,118KY $2,808
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.