How much rates vary
Facilitymedian $2,089 · 10th to 90th $407 to $4,074Professionalmedian $3,162 · 10th to 90th $1,479 to $13,804
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 $1,348.96 Median $1,348.96 Typical High $5,623.41 | Professional | None | $1,348.96 | $1,348.96 | $5,623.41 |
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 $1,513.56 Median $5,011.87 Typical High $13,803.84 | Professional | None | $1,513.56 | $5,011.87 | $13,803.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
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 $3,162.28 Median $3,162.28 Typical High $5,623.41 | Professional | None | $3,162.28 | $3,162.28 | $5,623.41 |
Fallon Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,630.78 | Facility | None | $2,089.30 | $2,570.40 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,570.40 | $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 $1,949.84 Median $4,168.69 Typical High $6,309.57 | Professional | None | $1,949.84 | $4,168.69 | $6,309.57 |
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 $1,513.56 Median $5,011.87 Typical High $13,803.84 | Professional | None | $1,513.56 | $5,011.87 | $13,803.84 |
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 $1,659.59 Median $3,162.28 Typical High $8,912.51 | Professional | None | $1,659.59 | $3,162.28 | $8,912.51 |
Well Sense Setting Facility Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,090.30 | Facility | None | $1,513.56 | $2,041.74 | $3,090.30 |
Well Sense Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,479.11 | $1,778.28 |
9 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 $676.08 Median $676.08 Typical High $2,754.23 | Professional | 52 · Reduced service | $676.08 | $676.08 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $1,122.02 | Professional | 53 · Discontinued | $269.15 | $269.15 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $4,168.69 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $831.76 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $562.34 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $3,890.45 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $2,238.72 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,698.24 | $2,238.72 | $2,951.21 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,884.03 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,884.03 | $3,801.89 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $436.52 Median $575.44 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $436.52 | $575.44 | $758.58 |
Where Massachusetts sits
The same service costs 7.2 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 $19,737WA $2,745
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.