How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,072 to $9,333Professionalmedian $2,570 · 10th to 90th $1,585 to $10,965
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 $6,309.57 | Facility | None | $2,691.53 | $3,388.44 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $4,677.35 | Professional | None | $1,513.56 | $1,513.56 | $4,677.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $758.58 Median $4,168.69 Typical High $12,882.50 | Facility | None | $758.58 | $4,168.69 | $12,882.50 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,778.28 Median $3,890.45 Typical High $10,964.78 | Professional | None | $1,778.28 | $3,890.45 | $10,964.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,548.13 | Professional | None | $1,659.59 | $1,659.59 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,456.54 Typical High $9,549.93 | Facility | None | $741.31 | $6,456.54 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,137.96 | $4,265.80 |
Fallon Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $3,311.31 | Facility | None | $1,659.59 | $2,041.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,454.71 | Professional | None | $1,819.70 | $2,137.96 | $2,454.71 |
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 $1,819.70 Median $3,311.31 Typical High $4,786.30 | Professional | None | $1,819.70 | $3,311.31 | $4,786.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $758.58 Median $4,168.69 Typical High $12,882.50 | Facility | None | $758.58 | $4,168.69 | $12,882.50 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,778.28 Median $3,890.45 Typical High $10,964.78 | Professional | None | $1,778.28 | $3,890.45 | $10,964.78 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $14,125.38 | Facility | None | $1,071.52 | $3,467.37 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $7,413.10 | Professional | None | $1,862.09 | $2,570.40 | $7,413.10 |
Well Sense Setting Facility Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,698.24 | $2,511.89 |
Well Sense Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,202.26 | $1,621.81 |
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 $758.58 Median $758.58 Typical High $2,344.23 | Professional | 52 · Reduced service | $758.58 | $758.58 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $933.25 | Professional | 53 · Discontinued | $302.00 | $302.00 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $707.95 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $467.74 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $3,311.31 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $457.09 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $457.09 | $602.56 |
Where Massachusetts sits
The same service costs 4.7 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 $16,761KY $3,604
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.