How much rates vary
Facilitymedian $2,692 · 10th to 90th $891 to $12,589Professionalmedian $1,950 · 10th to 90th $1,175 to $9,772
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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $3,388.44 | Professional | None | $1,122.02 | $1,122.02 | $3,388.44 |
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 $1,288.25 Median $2,951.21 Typical High $9,772.37 | Professional | None | $1,288.25 | $2,951.21 | $9,772.37 |
BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,288.25 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $13,182.57 Typical High $19,054.61 | Facility | None | $676.08 | $13,182.57 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,621.81 | $1,621.81 | $3,235.94 |
Fallon Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $3,311.31 | Facility | None | $1,148.15 | $1,548.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,621.81 | $1,905.46 |
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 $1,380.38 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,380.38 | $2,511.89 | $3,801.89 |
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 $1,288.25 Median $2,951.21 Typical High $9,772.37 | Professional | None | $1,288.25 | $2,951.21 | $9,772.37 |
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 $1,380.38 Median $1,862.09 Typical High $5,495.41 | Professional | None | $1,380.38 | $1,862.09 | $5,495.41 |
Well Sense Setting Facility Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $6,456.54 | Facility | None | $1,000.00 | $1,380.38 | $6,456.54 |
Well Sense Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
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 $562.34 Median $562.34 Typical High $1,698.24 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $691.83 | Professional | 53 · Discontinued | $223.87 | $223.87 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $2,570.40 | Professional | 54 · Surgery only | $851.14 | $851.14 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $512.86 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $338.84 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $2,398.83 |
Where Massachusetts sits
The same service costs 6.7 times more in Alaska than in Hawaii. 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 $22,390HI $3,327
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.