How much rates vary
Facilitymedian $1,995 · 10th to 90th $347 to $3,715Professionalmedian $2,884 · 10th to 90th $1,698 to $12,882
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 $2,691.53 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,288.25 | $2,187.76 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $1,047.13 Typical High $4,466.84 | Facility | None | $316.23 | $1,047.13 | $4,466.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,862.09 Median $4,570.88 Typical High $12,882.50 | Professional | None | $1,862.09 | $4,570.88 | $12,882.50 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,949.84 Median $3,090.30 Typical High $4,168.69 | Professional | None | $1,949.84 | $3,090.30 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $5,128.61 | Professional | None | $2,884.03 | $2,884.03 | $5,128.61 |
Fallon Health Setting Facility Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,388.44 | Facility | None | $1,949.84 | $2,398.83 | $3,388.44 |
Fallon Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,398.83 | $2,884.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,137.96 Median $3,890.45 Typical High $5,888.44 | Professional | None | $2,137.96 | $3,890.45 | $5,888.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $1,047.13 Typical High $4,466.84 | Facility | None | $316.23 | $1,047.13 | $4,466.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,862.09 Median $4,570.88 Typical High $12,882.50 | Professional | None | $1,862.09 | $4,570.88 | $12,882.50 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $8,317.64 | Professional | None | $2,290.87 | $3,162.28 | $8,317.64 |
Well Sense Setting Facility Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,818.38 | Facility | None | $1,380.38 | $1,905.46 | $2,818.38 |
Well Sense Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
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 $645.65 Median $645.65 Typical High $1,047.13 | Professional | 52 · Reduced service | $645.65 | $645.65 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $416.87 | Professional | 53 · Discontinued | $257.04 | $257.04 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,584.89 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $316.23 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $208.93 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,479.11 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,630.27 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,630.27 | $3,548.13 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $524.81 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $524.81 | $707.95 |
Where Massachusetts sits
The same service costs 8.0 times more in Alabama than in Washington. 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
AL $20,353WA $2,540
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.