How much rates vary
Facilitymedian $1,318 · 10th to 90th $617 to $4,266Professionalmedian $1,698 · 10th to 90th $933 to $4,266
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 $1,174.90 Median $2,691.53 Typical High $4,677.35 | Facility | None | $1,174.90 | $2,691.53 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $2,290.87 | Professional | None | $724.44 | $954.99 | $2,290.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,041.74 Typical High $5,623.41 | Facility | None | $549.54 | $2,041.74 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $912.01 Median $1,905.46 Typical High $8,317.64 | Professional | None | $912.01 | $1,905.46 | $8,317.64 |
BCBS Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,995.26 | Facility | None | $891.25 | $1,071.52 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,148.15 Typical High $1,698.24 | Facility | None | $676.08 | $1,148.15 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,951.21 | Professional | None | $1,122.02 | $1,445.44 | $2,951.21 |
Fallon Health Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $3,311.31 | Facility | None | $812.83 | $1,122.02 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,659.59 | $1,949.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $954.99 Median $1,949.84 Typical High $3,235.94 | Professional | None | $954.99 | $1,949.84 | $3,235.94 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,041.74 Typical High $5,623.41 | Facility | None | $549.54 | $2,041.74 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $912.01 Median $1,905.46 Typical High $8,317.64 | Professional | None | $912.01 | $1,905.46 | $8,317.64 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $6,309.57 | Facility | None | $1,047.13 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $4,265.80 | Professional | None | $977.24 | $1,621.81 | $4,265.80 |
Well Sense Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,659.59 | Facility | None | $602.56 | $1,000.00 | $1,659.59 |
Well Sense Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $812.83 | Professional | None | $562.34 | $676.08 | $812.83 |
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 $363.08 Median $478.63 Typical High $1,148.15 | Professional | 52 · Reduced service | $363.08 | $478.63 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $190.55 Typical High $457.09 | Professional | 53 · Discontinued | $144.54 | $190.55 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $707.95 Typical High $1,698.24 | Professional | 54 · Surgery only | $549.54 | $707.95 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $141.25 Typical High $338.84 | Professional | 55 · Aftercare only | $109.65 | $141.25 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $95.50 Typical High $229.09 | Professional | 56 · Pre-op care only | $72.44 | $95.50 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $660.69 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $512.86 | $660.69 | $1,584.89 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $229.09 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $229.09 | $323.59 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $588.84 |
Where Massachusetts sits
The same service costs 4.3 times more in Alabama than in Maryland. 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
AL $8,761MD $2,030
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.