How much rates vary
Facilitymedian $1,585 · 10th to 90th $447 to $7,586Professionalmedian $1,479 · 10th to 90th $229 to $14,791
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $446.68 | Professional | None | $169.82 | $229.09 | $446.68 |
AllWays Health Partners Setting Facility Modifier None Typical Low $489.78 Median $3,890.45 Typical High $8,912.51 | Facility | None | $489.78 | $3,890.45 | $8,912.51 |
AllWays Health Partners Setting Professional Modifier None Typical Low $245.47 Median $1,862.09 Typical High $35,481.34 | Professional | None | $245.47 | $1,862.09 | $35,481.34 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,174.90 | Facility | None | $501.19 | $501.19 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $11,481.54 Typical High $16,595.87 | Facility | None | $446.68 | $11,481.54 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,995.26 Typical High $6,760.83 | Professional | None | $630.96 | $1,995.26 | $6,760.83 |
Fallon Health Setting Facility Modifier None Typical Low $489.78 Median $645.65 Typical High $3,311.31 | Facility | None | $489.78 | $645.65 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $6,606.93 Median $7,585.78 Typical High $8,709.64 | Professional | None | $6,606.93 | $7,585.78 | $8,709.64 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $912.01 Median $3,890.45 Typical High $8,128.31 | Facility | None | $912.01 | $3,890.45 | $8,128.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $446.68 Median $1,513.56 Typical High $12,882.50 | Professional | None | $446.68 | $1,513.56 | $12,882.50 |
Mass General Brigham Setting Facility Modifier None Typical Low $489.78 Median $3,890.45 Typical High $8,912.51 | Facility | None | $489.78 | $3,890.45 | $8,912.51 |
Mass General Brigham Setting Professional Modifier None Typical Low $245.47 Median $1,862.09 Typical High $35,481.34 | Professional | None | $245.47 | $1,862.09 | $35,481.34 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $15,488.17 | Facility | None | $1,071.52 | $3,890.45 | $15,488.17 |
United Setting Professional Modifier None Typical Low $239.88 Median $1,230.27 Typical High $10,232.93 | Professional | None | $239.88 | $1,230.27 | $10,232.93 |
Well Sense Setting Facility Modifier None Typical Low $354.81 Median $2,238.72 Typical High $4,365.16 | Facility | None | $354.81 | $2,238.72 | $4,365.16 |
Well Sense Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $181.97 | Professional | None | $117.49 | $151.36 | $181.97 |
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 $85.11 Median $114.82 Typical High $223.87 | Professional | 52 · Reduced service | $85.11 | $114.82 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $45.71 Typical High $89.13 | Professional | 53 · Discontinued | $33.88 | $45.71 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $338.84 | Professional | 54 · Surgery only | $128.82 | $173.78 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $67.61 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $22.91 Typical High $44.67 | Professional | 56 · Pre-op care only | $16.98 | $22.91 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $162.18 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $120.23 | $162.18 | $316.23 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $97.72 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $74.13 | $97.72 | $131.83 |
Where Massachusetts sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.