How much rates vary
Facilitymedian $1,288 · 10th to 90th $631 to $4,266Professionalmedian $1,148 · 10th to 90th $759 to $5,012
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 $1,995.26 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,995.26 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,995.26 | Professional | None | $758.58 | $758.58 | $1,995.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $1,698.24 Typical High $4,168.69 | Facility | None | $549.54 | $1,698.24 | $4,168.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $741.31 Median $1,737.80 Typical High $5,011.87 | Professional | None | $741.31 | $1,737.80 | $5,011.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,621.81 | Professional | None | $758.58 | $758.58 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,819.70 | Facility | None | $676.08 | $1,258.93 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,023.29 | $1,905.46 |
Fallon Health Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $3,311.31 | Facility | None | $724.44 | $954.99 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,122.02 | Professional | None | $831.76 | $977.24 | $1,122.02 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $812.83 Median $1,479.11 Typical High $2,454.71 | Professional | None | $812.83 | $1,479.11 | $2,454.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $1,698.24 Typical High $4,168.69 | Facility | None | $549.54 | $1,698.24 | $4,168.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $741.31 Median $1,737.80 Typical High $5,011.87 | Professional | None | $741.31 | $1,737.80 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,244.36 | Facility | None | $1,047.13 | $2,344.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $3,090.30 | Professional | None | $776.25 | $1,122.02 | $3,090.30 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $1,071.52 | Facility | None | $562.34 | $676.08 | $1,071.52 |
Well Sense Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | None | $512.86 | $512.86 | $691.83 |
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 $380.19 Median $380.19 Typical High $1,000.00 | Professional | 52 · Reduced service | $380.19 | $380.19 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $398.11 | Professional | 53 · Discontinued | $151.36 | $151.36 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $1,513.56 | Professional | 54 · Surgery only | $562.34 | $562.34 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $302.00 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $199.53 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $1,412.54 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $199.53 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $199.53 | $275.42 |
Where Massachusetts sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.