How much rates vary
Facilitymedian $2,089 · 10th to 90th $407 to $4,074Professionalmedian $3,311 · 10th to 90th $1,905 to $14,125
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 $1,445.44 Median $1,445.44 Typical High $6,456.54 | Professional | None | $1,445.44 | $1,445.44 | $6,456.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,897.79 | Facility | None | $346.74 | $1,047.13 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,041.74 Median $5,011.87 Typical High $14,125.38 | Professional | None | $2,041.74 | $5,011.87 | $14,125.38 |
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 $3,235.94 Median $3,235.94 Typical High $5,754.40 | Professional | None | $3,235.94 | $3,235.94 | $5,754.40 |
Fallon Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $3,630.78 | Facility | None | $2,137.96 | $2,630.27 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,630.27 | $3,162.28 |
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 $2,344.23 Median $4,265.80 Typical High $6,456.54 | Professional | None | $2,344.23 | $4,265.80 | $6,456.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,897.79 | Facility | None | $346.74 | $1,047.13 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,041.74 Median $5,011.87 Typical High $14,125.38 | Professional | None | $2,041.74 | $5,011.87 | $14,125.38 |
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 $3,548.13 Typical High $9,332.54 | Professional | None | $2,454.71 | $3,548.13 | $9,332.54 |
Well Sense Setting Facility Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,162.28 | Facility | None | $1,513.56 | $2,041.74 | $3,162.28 |
Well Sense Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,659.59 | $1,995.26 |
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 $724.44 Median $724.44 Typical High $3,235.94 | Professional | 52 · Reduced service | $724.44 | $724.44 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $1,288.25 | Professional | 53 · Discontinued | $288.40 | $288.40 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $4,897.79 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $977.24 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $645.65 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $4,570.88 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued + 62 · Two surgeons Typical Low $426.58 Median $562.34 Typical High $741.31 | Professional | 53 · Discontinued + 62 · Two surgeons | $426.58 | $562.34 | $741.31 |
Where Massachusetts sits
The same service costs 7.3 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 $20,260WA $2,785
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.