How much rates vary
Facilitymedian $1,318 · 10th to 90th $407 to $3,548Professionalmedian $1,820 · 10th to 90th $1,023 to $8,128
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 $2,691.53 Median $3,090.30 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $3,162.28 | Professional | None | $870.96 | $870.96 | $3,162.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $912.01 Typical High $3,548.13 | Facility | None | $346.74 | $912.01 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,148.15 Median $3,090.30 Typical High $8,128.31 | Professional | None | $1,148.15 | $3,090.30 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,621.81 | $1,778.28 | $3,090.30 |
Fallon Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $3,311.31 | Facility | None | $1,230.27 | $1,548.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,548.82 | $1,905.46 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $3,548.13 | Professional | None | $1,318.26 | $2,454.71 | $3,548.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $912.01 Typical High $3,548.13 | Facility | None | $346.74 | $912.01 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,148.15 Median $3,090.30 Typical High $8,128.31 | Professional | None | $1,148.15 | $3,090.30 | $8,128.31 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $4,570.88 | Professional | None | $1,202.26 | $1,621.81 | $4,570.88 |
Well Sense Setting Facility Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,698.24 | Facility | None | $831.76 | $1,122.02 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | None | $831.76 | $831.76 | $1,000.00 |
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 $426.58 Median $426.58 Typical High $1,584.89 | Professional | 52 · Reduced service | $426.58 | $426.58 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $645.65 | Professional | 53 · Discontinued | $173.78 | $173.78 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $2,398.83 | Professional | 54 · Surgery only | $645.65 | $645.65 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $478.63 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $316.23 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $2,238.72 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,479.11 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,230.27 | $1,479.11 | $3,467.37 |
Where Massachusetts sits
The same service costs 6.8 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
$1,778
AK $4,571TX $676
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.