How much rates vary
Facilitymedian $1,585 · 10th to 90th $562 to $5,623Professionalmedian $851 · 10th to 90th $537 to $4,365
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 $489.78 Median $489.78 Typical High $1,479.11 | Professional | None | $489.78 | $489.78 | $1,479.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $562.34 Median $2,041.74 Typical High $5,754.40 | Facility | None | $562.34 | $2,041.74 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $575.44 Median $1,288.25 Typical High $4,365.16 | Professional | None | $575.44 | $1,288.25 | $4,365.16 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,258.93 | Professional | None | $575.44 | $575.44 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,187.76 Typical High $3,162.28 | Facility | None | $676.08 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,380.38 | Professional | None | $707.95 | $707.95 | $1,380.38 |
Fallon Health Setting Facility Modifier None Typical Low $562.34 Median $741.31 Typical High $3,311.31 | Facility | None | $562.34 | $741.31 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $851.14 | Professional | None | $630.96 | $741.31 | $851.14 |
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 $616.60 Median $1,122.02 Typical High $1,698.24 | Professional | None | $616.60 | $1,122.02 | $1,698.24 |
Mass General Brigham Setting Facility Modifier None Typical Low $562.34 Median $2,041.74 Typical High $5,754.40 | Facility | None | $562.34 | $2,041.74 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $575.44 Median $1,288.25 Typical High $4,365.16 | Professional | None | $575.44 | $1,288.25 | $4,365.16 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $2,398.83 | Professional | None | $602.56 | $812.83 | $2,398.83 |
Well Sense Setting Facility Modifier None Typical Low $446.68 Median $707.95 Typical High $1,096.48 | Facility | None | $446.68 | $707.95 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $512.86 | Professional | None | $380.19 | $380.19 | $512.86 |
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 $245.47 Median $245.47 Typical High $741.31 | Professional | 52 · Reduced service | $245.47 | $245.47 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $302.00 | Professional | 53 · Discontinued | $97.72 | $97.72 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $1,122.02 | Professional | 54 · Surgery only | $363.08 | $363.08 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $223.87 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $147.91 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $1,047.13 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $158.49 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $158.49 | $208.93 |
Where Massachusetts sits
The same service costs 4.5 times more in Connecticut 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
CT $7,632MT $1,703
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.