How much rates vary
Facilitymedian $2,042 · 10th to 90th $575 to $6,166Professionalmedian $912 · 10th to 90th $575 to $4,266
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 $1,778.28 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,584.89 | Professional | None | $512.86 | $512.86 | $1,584.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,187.76 Typical High $5,754.40 | Facility | None | $549.54 | $2,187.76 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $616.60 Median $1,380.38 Typical High $4,265.80 | Professional | None | $616.60 | $1,380.38 | $4,265.80 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,348.96 | Professional | None | $616.60 | $616.60 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,677.35 Typical High $7,079.46 | Facility | None | $676.08 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,513.56 | Professional | None | $758.58 | $758.58 | $1,513.56 |
Fallon Health Setting Facility Modifier None Typical Low $602.56 Median $794.33 Typical High $3,311.31 | Facility | None | $602.56 | $794.33 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $912.01 | Professional | None | $676.08 | $794.33 | $912.01 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $660.69 Median $1,202.26 Typical High $1,819.70 | Professional | None | $660.69 | $1,202.26 | $1,819.70 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,187.76 Typical High $5,754.40 | Facility | None | $549.54 | $2,187.76 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $616.60 Median $1,380.38 Typical High $4,265.80 | Professional | None | $616.60 | $1,380.38 | $4,265.80 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $12,302.69 | Facility | None | $851.14 | $2,818.38 | $12,302.69 |
United Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $2,511.89 | Professional | None | $645.65 | $891.25 | $2,511.89 |
Well Sense Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $2,398.83 | Facility | None | $467.74 | $758.58 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
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 $257.04 Median $257.04 Typical High $794.33 | Professional | 52 · Reduced service | $257.04 | $257.04 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $316.23 | Professional | 53 · Discontinued | $102.33 | $102.33 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $1,174.90 | Professional | 54 · Surgery only | $389.05 | $389.05 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $234.42 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $158.49 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $1,096.48 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $169.82 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $169.82 | $223.87 |
Where Massachusetts sits
The same service costs 7.6 times more in Alaska than in Texas. 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.
Massachusetts· 18th of 51
$912
AK $2,344TX $309
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.