How much rates vary
Facilitymedian $2,692 · 10th to 90th $794 to $9,333Professionalmedian $1,259 · 10th to 90th $794 to $5,370
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 $724.44 Median $724.44 Typical High $2,238.72 | Professional | None | $724.44 | $724.44 | $2,238.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $12,022.64 | Facility | None | $707.95 | $3,890.45 | $12,022.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $831.76 Median $1,905.46 Typical High $5,370.32 | Professional | None | $831.76 | $1,905.46 | $5,370.32 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,778.28 | Professional | None | $831.76 | $831.76 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $6,760.83 Typical High $9,772.37 | Facility | None | $831.76 | $6,760.83 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,047.13 | $2,089.30 |
Fallon Health Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $3,311.31 | Facility | None | $794.33 | $1,023.29 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,230.27 | Professional | None | $912.01 | $1,047.13 | $1,230.27 |
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 $891.25 Median $1,621.81 Typical High $2,454.71 | Professional | None | $891.25 | $1,621.81 | $2,454.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $12,022.64 | Facility | None | $707.95 | $3,890.45 | $12,022.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $831.76 Median $1,905.46 Typical High $5,370.32 | Professional | None | $831.76 | $1,905.46 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $3,548.13 | Professional | None | $891.25 | $1,202.26 | $3,548.13 |
Well Sense Setting Facility Modifier None Typical Low $645.65 Median $1,023.29 Typical High $3,630.78 | Facility | None | $645.65 | $1,023.29 | $3,630.78 |
Well Sense Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $758.58 | Professional | None | $562.34 | $562.34 | $758.58 |
6 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 $363.08 Typical High $1,096.48 | Professional | 52 · Reduced service | $363.08 | $363.08 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $446.68 | Professional | 53 · Discontinued | $144.54 | $144.54 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $1,659.59 | Professional | 54 · Surgery only | $549.54 | $549.54 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $331.13 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $223.87 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $1,548.82 |
Where Massachusetts sits
The same service costs 5.9 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 $14,644MT $2,489
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.