How much rates vary
Facilitymedian $2,692 · 10th to 90th $646 to $13,183Professionalmedian $977 · 10th to 90th $617 to $4,467
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 $1,819.70 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,819.70 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,819.70 | Professional | None | $562.34 | $562.34 | $1,819.70 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $14,454.40 | Facility | None | $707.95 | $3,890.45 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $660.69 Median $1,479.11 Typical High $4,466.84 | Professional | None | $660.69 | $1,479.11 | $4,466.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,412.54 | Professional | None | $660.69 | $660.69 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $12,022.64 Typical High $18,197.01 | Facility | None | $831.76 | $12,022.64 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,621.81 | Professional | None | $812.83 | $812.83 | $1,621.81 |
Fallon Health Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $3,311.31 | Facility | None | $645.65 | $812.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $977.24 | Professional | None | $724.44 | $831.76 | $977.24 |
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 $691.83 Median $1,288.25 Typical High $1,949.84 | Professional | None | $691.83 | $1,288.25 | $1,949.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $14,454.40 | Facility | None | $707.95 | $3,890.45 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $660.69 Median $1,479.11 Typical High $4,466.84 | Professional | None | $660.69 | $1,479.11 | $4,466.84 |
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 $691.83 Median $977.24 Typical High $2,691.53 | Professional | None | $691.83 | $977.24 | $2,691.53 |
Well Sense Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $7,585.78 | Facility | None | $501.19 | $812.83 | $7,585.78 |
Well Sense Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $602.56 | Professional | None | $446.68 | $446.68 | $602.56 |
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 $281.84 Median $281.84 Typical High $891.25 | Professional | 52 · Reduced service | $281.84 | $281.84 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $363.08 | Professional | 53 · Discontinued | $112.20 | $112.20 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $1,348.96 | Professional | 54 · Surgery only | $416.87 | $416.87 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $269.15 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $181.97 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $1,258.93 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $177.83 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $177.83 | $239.88 |
BCBS Massachusetts Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $141.25 Typical High $257.04 | Professional | AS · PA/NP assist | $100.00 | $141.25 | $257.04 |
Where Massachusetts sits
The same service costs 10.1 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 $19,890MT $1,977
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.