How much rates vary
Facilitymedian $1,072 · 10th to 90th $398 to $5,370Professionalmedian $776 · 10th to 90th $407 to $1,820
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 $851.14 Median $2,691.53 Typical High $4,677.35 | Facility | None | $851.14 | $2,691.53 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $1,047.13 | Professional | None | $331.13 | $537.03 | $1,047.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $5,623.41 | Facility | None | $512.86 | $2,041.74 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $436.52 Median $891.25 Typical High $4,265.80 | Professional | None | $436.52 | $891.25 | $4,265.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $398.11 Median $478.63 Typical High $912.01 | Facility | None | $398.11 | $478.63 | $912.01 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $398.11 Median $660.69 Typical High $1,148.15 | Professional | None | $398.11 | $660.69 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,677.35 Typical High $7,079.46 | Facility | None | $676.08 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,348.96 | Professional | None | $489.78 | $741.31 | $1,348.96 |
Fallon Health Setting Facility Modifier None Typical Low $389.05 Median $512.86 Typical High $3,311.31 | Facility | None | $389.05 | $512.86 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $977.24 | Professional | None | $741.31 | $851.14 | $977.24 |
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 $436.52 Median $891.25 Typical High $1,621.81 | Professional | None | $436.52 | $891.25 | $1,621.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $5,623.41 | Facility | None | $512.86 | $2,041.74 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $436.52 Median $891.25 Typical High $4,265.80 | Professional | None | $436.52 | $891.25 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $11,481.54 | Facility | None | $1,047.13 | $2,344.23 | $11,481.54 |
United Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,621.81 | Professional | None | $457.09 | $741.31 | $1,621.81 |
Well Sense Setting Facility Modifier None Typical Low $323.59 Median $562.34 Typical High $2,398.83 | Facility | None | $323.59 | $562.34 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $457.09 | Professional | None | $263.03 | $354.81 | $457.09 |
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 $165.96 Median $263.03 Typical High $524.81 | Professional | 52 · Reduced service | $165.96 | $263.03 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $107.15 Typical High $208.93 | Professional | 53 · Discontinued | $67.61 | $107.15 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $794.33 | Professional | 54 · Surgery only | $251.19 | $398.11 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $79.43 Typical High $158.49 | Professional | 55 · Aftercare only | $50.12 | $79.43 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $53.70 Typical High $104.71 | Professional | 56 · Pre-op care only | $33.11 | $53.70 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $741.31 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $389.05 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $316.23 | $389.05 | $691.83 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $239.88 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $165.96 | $239.88 | $323.59 |
Where Massachusetts sits
The same service costs 6.4 times more in Alaska than in Montana. 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 $8,723MT $1,361
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.