How much rates vary
Facilitymedian $2,884 · 10th to 90th $407 to $4,898Professionalmedian $4,786 · 10th to 90th $2,630 to $27,542
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 $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $5,248.07 | Professional | None | $2,137.96 | $2,137.96 | $5,248.07 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $7,413.10 | Facility | None | $346.74 | $1,047.13 | $7,413.10 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,951.21 Median $7,762.47 Typical High $27,542.29 | Professional | None | $2,951.21 | $7,762.47 | $27,542.29 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Professional | None | $12,589.25 | $12,589.25 | $12,589.25 |
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 $4,786.30 Median $4,786.30 Typical High $8,511.38 | Professional | None | $4,786.30 | $4,786.30 | $8,511.38 |
Fallon Health Setting Facility Modifier None Typical Low $3,162.28 Median $4,073.80 Typical High $4,897.79 | Facility | None | $3,162.28 | $4,073.80 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $4,897.79 | Professional | None | $3,467.37 | $4,073.80 | $4,897.79 |
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 $3,630.78 Median $6,606.93 Typical High $10,000.00 | Professional | None | $3,630.78 | $6,606.93 | $10,000.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $7,413.10 | Facility | None | $346.74 | $1,047.13 | $7,413.10 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,951.21 Median $7,762.47 Typical High $27,542.29 | Professional | None | $2,951.21 | $7,762.47 | $27,542.29 |
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 $3,467.37 Median $5,011.87 Typical High $13,803.84 | Professional | None | $3,467.37 | $5,011.87 | $13,803.84 |
Well Sense Setting Facility Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $4,677.35 | Facility | None | $2,290.87 | $3,090.30 | $4,677.35 |
Well Sense Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,454.71 | $2,951.21 |
8 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 $1,071.52 Median $1,071.52 Typical High $4,677.35 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $4,677.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $1,862.09 | Professional | 53 · Discontinued | $426.58 | $426.58 | $1,862.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $7,079.46 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $7,079.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $1,412.54 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $1,412.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $933.25 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $933.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $6,606.93 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $6,606.93 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $2,691.53 Median $3,548.13 Typical High $4,677.35 | Professional | 62 · Two surgeons | $2,691.53 | $3,548.13 | $4,677.35 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $691.83 Median $891.25 Typical High $1,174.90 | Professional | 82 · Assistant surgeon, no resident | $691.83 | $891.25 | $1,174.90 |
Where Massachusetts sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 20th of 51
$4,467
AK $12,589AR $1,995
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.