How much rates vary
Facilitymedian $2,399 · 10th to 90th $407 to $4,365Professionalmedian $3,631 · 10th to 90th $1,905 to $19,953
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 $3,090.30 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $3,715.35 | Professional | None | $1,584.89 | $1,584.89 | $3,715.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,754.40 | Facility | None | $346.74 | $1,047.13 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,995.26 Median $5,888.44 Typical High $19,952.62 | Professional | None | $1,995.26 | $5,888.44 | $19,952.62 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $2,454.71 Median $3,981.07 Typical High $5,370.32 | Professional | None | $2,454.71 | $3,981.07 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $6,456.54 | Professional | None | $3,630.78 | $3,630.78 | $6,456.54 |
Fallon Health Setting Facility Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,715.35 | Facility | None | $2,511.89 | $3,090.30 | $3,715.35 |
Fallon Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,630.27 | $3,090.30 | $3,715.35 |
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 $2,691.53 Median $5,011.87 Typical High $7,585.78 | Professional | None | $2,691.53 | $5,011.87 | $7,585.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,754.40 | Facility | None | $346.74 | $1,047.13 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,995.26 Median $5,888.44 Typical High $19,952.62 | Professional | None | $1,995.26 | $5,888.44 | $19,952.62 |
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 $2,454.71 Median $3,801.89 Typical High $10,471.29 | Professional | None | $2,454.71 | $3,801.89 | $10,471.29 |
Well Sense Setting Facility Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $3,548.13 | Facility | None | $1,737.80 | $2,344.23 | $3,548.13 |
Well Sense Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
7 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 $794.33 Median $794.33 Typical High $3,467.37 | Professional | 52 · Reduced service | $794.33 | $794.33 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $1,380.38 | Professional | 53 · Discontinued | $316.23 | $316.23 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $5,128.61 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $1,023.29 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $691.83 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $4,786.30 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $524.81 Median $676.08 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $524.81 | $676.08 | $912.01 |
Where Massachusetts sits
The same service costs 7.1 times more in Alaska 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
AK $21,795WA $3,065
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.