How much rates vary
Facilitymedian $1,950 · 10th to 90th $794 to $13,804Professionalmedian $1,202 · 10th to 90th $759 to $5,888
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 $2,290.87 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,290.87 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $2,290.87 | Professional | None | $724.44 | $724.44 | $2,290.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $831.76 Median $4,073.80 Typical High $25,118.86 | Facility | None | $831.76 | $4,073.80 | $25,118.86 |
AllWays Health Partners Setting Professional Modifier None Typical Low $831.76 Median $1,819.70 Typical High $5,888.44 | Professional | None | $831.76 | $1,819.70 | $5,888.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,698.24 | Professional | None | $794.33 | $794.33 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $3,162.28 | Facility | None | $741.31 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,000.00 | $1,949.84 |
Fallon Health Setting Facility Modifier None Typical Low $794.33 Median $1,000.00 Typical High $3,311.31 | Facility | None | $794.33 | $1,000.00 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,174.90 | Professional | None | $870.96 | $1,000.00 | $1,174.90 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,096.48 | $4,073.80 | $14,125.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $870.96 Median $1,584.89 Typical High $2,238.72 | Professional | None | $870.96 | $1,584.89 | $2,238.72 |
Mass General Brigham Setting Facility Modifier None Typical Low $831.76 Median $4,073.80 Typical High $25,118.86 | Facility | None | $831.76 | $4,073.80 | $25,118.86 |
Mass General Brigham Setting Professional Modifier None Typical Low $831.76 Median $1,819.70 Typical High $5,888.44 | Professional | None | $831.76 | $1,819.70 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,258.93 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $3,388.44 | Professional | None | $891.25 | $1,202.26 | $3,388.44 |
Well Sense Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $1,174.90 | Facility | None | $575.44 | $794.33 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | None | $588.84 | $588.84 | $794.33 |
9 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 $363.08 Median $363.08 Typical High $1,148.15 | Professional | 52 · Reduced service | $363.08 | $363.08 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $457.09 | Professional | 53 · Discontinued | $144.54 | $144.54 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $1,737.80 | Professional | 54 · Surgery only | $549.54 | $549.54 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $346.74 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $229.09 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $1,621.81 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $676.08 Typical High $891.25 | Professional | 52 · Reduced service | $398.11 | $676.08 | $891.25 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $851.14 Typical High $1,122.02 | Professional | 62 · Two surgeons | $489.78 | $851.14 | $1,122.02 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,071.52 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $630.96 | $1,071.52 | $1,445.44 |
Where Massachusetts sits
The same service costs 4.3 times more in Alaska than in Texas. 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 $9,769TX $2,271
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.