How much rates vary
Facilitymedian $407 · 10th to 90th $174 to $3,548Professionalmedian $355 · 10th to 90th $209 to $1,549
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 $154.88 Median $154.88 Typical High $263.03 | Professional | None | $154.88 | $154.88 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $173.78 Median $776.25 Typical High $3,630.78 | Facility | None | $173.78 | $776.25 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $208.93 Median $524.81 Typical High $1,548.82 | Professional | None | $208.93 | $524.81 | $1,548.82 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $501.19 | Professional | None | $234.42 | $371.54 | $501.19 |
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 $354.81 Median $354.81 Typical High $630.96 | Professional | None | $354.81 | $354.81 | $630.96 |
Fallon Health Setting Facility Modifier None Typical Low $234.42 Median $295.12 Typical High $3,311.31 | Facility | None | $234.42 | $295.12 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $346.74 | Professional | None | $251.19 | $288.40 | $346.74 |
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 $263.03 Median $478.63 Typical High $724.44 | Professional | None | $263.03 | $478.63 | $724.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $173.78 Median $776.25 Typical High $3,630.78 | Facility | None | $173.78 | $776.25 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $208.93 Median $524.81 Typical High $1,548.82 | Professional | None | $208.93 | $524.81 | $1,548.82 |
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 $281.84 Median $380.19 Typical High $1,023.29 | Professional | None | $281.84 | $380.19 | $1,023.29 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $331.13 | Facility | None | $162.18 | $208.93 | $331.13 |
Well Sense Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | None | $162.18 | $162.18 | $194.98 |
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 $77.62 Median $77.62 Typical High $131.83 | Professional | 52 · Reduced service | $77.62 | $77.62 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $52.48 | Professional | 53 · Discontinued | $30.90 | $30.90 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $194.98 | Professional | 54 · Surgery only | $114.82 | $114.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $39.81 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $26.30 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $245.47 | $316.23 | $426.58 |
Where Massachusetts sits
The same service costs 7.3 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 $5,199MT $710
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.