How much rates vary
Facilitymedian $2,692 · 10th to 90th $407 to $4,365Professionalmedian $4,169 · 10th to 90th $1,950 to $22,387
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 $1,778.28 Median $1,778.28 Typical High $4,466.84 | Professional | None | $1,778.28 | $1,778.28 | $4,466.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,456.54 | Facility | None | $346.74 | $1,047.13 | $6,456.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,041.74 Median $6,606.93 Typical High $22,387.21 | Professional | None | $2,041.74 | $6,606.93 | $22,387.21 |
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 $4,168.69 Median $4,168.69 Typical High $7,413.10 | Professional | None | $4,168.69 | $4,168.69 | $7,413.10 |
Fallon Health Setting Facility Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $4,168.69 | Facility | None | $2,818.38 | $3,467.37 | $4,168.69 |
Fallon Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $4,168.69 | Professional | None | $2,951.21 | $3,467.37 | $4,168.69 |
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 $2,884.03 Median $5,623.41 Typical High $8,511.38 | Professional | None | $2,884.03 | $5,623.41 | $8,511.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,456.54 | Facility | None | $346.74 | $1,047.13 | $6,456.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,041.74 Median $6,606.93 Typical High $22,387.21 | Professional | None | $2,041.74 | $6,606.93 | $22,387.21 |
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 $2,511.89 Median $4,265.80 Typical High $12,022.64 | Professional | None | $2,511.89 | $4,265.80 | $12,022.64 |
Well Sense Setting Facility Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $4,073.80 | Facility | None | $1,949.84 | $2,630.27 | $4,073.80 |
Well Sense Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,041.74 | $2,454.71 |
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 $891.25 Median $891.25 Typical High $3,890.45 | Professional | 52 · Reduced service | $891.25 | $891.25 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $1,548.82 | Professional | 53 · Discontinued | $354.81 | $354.81 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $5,754.40 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $1,148.15 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $776.25 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $5,370.32 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service + 82 · Assistant surgeon, no resident Typical Low $295.12 Median $380.19 Typical High $512.86 | Professional | 52 · Reduced service + 82 · Assistant surgeon, no resident | $295.12 | $380.19 | $512.86 |
Where Massachusetts sits
The same service costs 6.9 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 $22,987WA $3,314
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.