How much rates vary
Facilitymedian $363 · 10th to 90th $141 to $3,162Professionalmedian $427 · 10th to 90th $269 to $1,175
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 $758.58 Median $2,187.76 Typical High $3,630.78 | Facility | None | $758.58 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $758.58 | Professional | None | $245.47 | $275.42 | $758.58 |
AllWays Health Partners Setting Facility Modifier None Typical Low $141.25 Median $724.44 Typical High $4,073.80 | Facility | None | $141.25 | $724.44 | $4,073.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $275.42 Median $512.86 Typical High $2,041.74 | Professional | None | $275.42 | $512.86 | $2,041.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $575.44 | Facility | None | $257.04 | $309.03 | $575.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $575.44 | Professional | None | $257.04 | $302.00 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $194.98 Typical High $281.84 | Facility | None | $53.70 | $194.98 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $724.44 | Professional | None | $316.23 | $354.81 | $724.44 |
Fallon Health Setting Facility Modifier None Typical Low $251.19 Median $331.13 Typical High $3,311.31 | Facility | None | $251.19 | $331.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $446.68 | Professional | None | $331.13 | $389.05 | $446.68 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $275.42 Median $537.03 Typical High $812.83 | Professional | None | $275.42 | $537.03 | $812.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $141.25 Median $724.44 Typical High $4,073.80 | Facility | None | $141.25 | $724.44 | $4,073.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $275.42 Median $512.86 Typical High $2,041.74 | Professional | None | $275.42 | $512.86 | $2,041.74 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,630.78 | Facility | None | $123.03 | $549.54 | $3,630.78 |
United Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $1,174.90 | Professional | None | $316.23 | $416.87 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $269.15 Typical High $467.74 | Facility | None | $141.25 | $269.15 | $467.74 |
Well Sense Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $257.04 | Professional | None | $190.55 | $208.93 | $257.04 |
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 $123.03 Median $138.04 Typical High $371.54 | Professional | 52 · Reduced service | $123.03 | $138.04 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $54.95 Typical High $151.36 | Professional | 53 · Discontinued | $48.98 | $54.95 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $562.34 | Professional | 54 · Surgery only | $181.97 | $204.17 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $41.69 Typical High $112.20 | Professional | 55 · Aftercare only | $36.31 | $41.69 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $27.54 Typical High $75.86 | Professional | 56 · Pre-op care only | $24.55 | $27.54 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $190.55 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $169.82 | $190.55 | $524.81 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $40.74 Median $66.07 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $40.74 | $66.07 | $93.33 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $131.83 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $131.83 | $181.97 |
Where Massachusetts sits
The same service costs 10.5 times more in Colorado than in Florida. 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
CO $4,157FL $396
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.