How much rates vary
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 $1,949.84 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,235.94 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,148.15 | $3,388.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $3,981.07 Typical High $14,454.40 | Facility | None | $707.95 | $3,981.07 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,380.38 Median $3,162.28 Typical High $8,912.51 | Professional | None | $1,380.38 | $3,162.28 | $8,912.51 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $11,220.18 Typical High $16,982.44 | Facility | None | $831.76 | $11,220.18 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,737.80 | $1,737.80 | $3,388.44 |
Fallon Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $3,311.31 | Facility | None | $1,230.27 | $1,698.24 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,737.80 | $2,041.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,445.44 Median $2,691.53 Typical High $4,073.80 | Professional | None | $1,445.44 | $2,691.53 | $4,073.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $3,981.07 Typical High $14,454.40 | Facility | None | $707.95 | $3,981.07 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,380.38 Median $3,162.28 Typical High $8,912.51 | Professional | None | $1,380.38 | $3,162.28 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $19,054.61 | Facility | None | $1,071.52 | $3,890.45 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $5,623.41 | Professional | None | $1,445.44 | $1,995.26 | $5,623.41 |
Well Sense Setting Facility Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $7,079.46 | Facility | None | $1,047.13 | $1,479.11 | $7,079.46 |
Well Sense Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
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 $575.44 Median $575.44 Typical High $1,698.24 | Professional | 52 · Reduced service | $575.44 | $575.44 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $676.08 | Professional | 53 · Discontinued | $229.09 | $229.09 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $2,570.40 | Professional | 54 · Surgery only | $870.96 | $870.96 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $512.86 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $338.84 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $2,398.83 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $371.54 Typical High $501.19 | Professional | 80 · Assistant surgeon | $218.78 | $371.54 | $501.19 |
Where Massachusetts sits
The same service costs 7.4 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· 14th of 51
$2,089
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.