How much rates vary
Facilitymedian $2,692 · 10th to 90th $832 to $15,849Professionalmedian $2,042 · 10th to 90th $1,122 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 $1,949.84 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $3,019.95 | Professional | None | $954.99 | $954.99 | $3,019.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $4,073.80 Typical High $16,218.10 | Facility | None | $707.95 | $4,073.80 | $16,218.10 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,202.26 Median $2,951.21 Typical High $10,000.00 | Professional | None | $1,202.26 | $2,951.21 | $10,000.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,235.94 | Professional | None | $1,513.56 | $1,513.56 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $12,589.25 Typical High $18,197.01 | Facility | None | $741.31 | $12,589.25 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,412.54 | $2,818.38 |
Fallon Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,380.38 | $1,862.09 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,698.24 | $1,949.84 | $2,238.72 |
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 $1,412.54 Median $2,884.03 Typical High $4,073.80 | Professional | None | $1,412.54 | $2,884.03 | $4,073.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $4,073.80 Typical High $16,218.10 | Facility | None | $707.95 | $4,073.80 | $16,218.10 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,202.26 Median $2,951.21 Typical High $10,000.00 | Professional | None | $1,202.26 | $2,951.21 | $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 $1,698.24 Typical High $4,786.30 | Professional | None | $1,230.27 | $1,698.24 | $4,786.30 |
Well Sense Setting Facility Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,659.59 | Facility | None | $812.83 | $1,096.48 | $1,659.59 |
Well Sense Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,023.29 | Professional | None | $758.58 | $758.58 | $1,023.29 |
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 $478.63 Median $478.63 Typical High $1,513.56 | Professional | 52 · Reduced service | $478.63 | $478.63 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $602.56 | Professional | 53 · Discontinued | $190.55 | $190.55 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $2,238.72 | Professional | 54 · Surgery only | $724.44 | $724.44 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $446.68 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $302.00 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $2,089.30 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $1,288.25 Typical High $1,737.80 | Professional | 52 · Reduced service | $758.58 | $1,288.25 | $1,737.80 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,621.81 Typical High $2,137.96 | Professional | 62 · Two surgeons | $954.99 | $1,621.81 | $2,137.96 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,584.89 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,584.89 | $2,754.23 |
Where Massachusetts sits
The same service costs 6.0 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 $15,585KY $2,601
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.