How much rates vary
Facilitymedian $1,862 · 10th to 90th $407 to $4,074Professionalmedian $2,754 · 10th to 90th $1,585 to $23,442
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 $5,248.07 | Facility | None | $2,691.53 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $5,248.07 | Professional | None | $1,174.90 | $1,174.90 | $5,248.07 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,365.16 | Facility | None | $346.74 | $1,047.13 | $4,365.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,778.28 Median $4,365.16 Typical High $23,442.29 | Professional | None | $1,778.28 | $4,365.16 | $23,442.29 |
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 $2,691.53 Median $2,691.53 Typical High $4,786.30 | Professional | None | $2,691.53 | $2,691.53 | $4,786.30 |
Fallon Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,311.31 | Facility | None | $1,819.70 | $2,238.72 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,238.72 | $2,754.23 |
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 $2,041.74 Median $3,715.35 Typical High $5,623.41 | Professional | None | $2,041.74 | $3,715.35 | $5,623.41 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,365.16 | Facility | None | $346.74 | $1,047.13 | $4,365.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,778.28 Median $4,365.16 Typical High $23,442.29 | Professional | None | $1,778.28 | $4,365.16 | $23,442.29 |
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 $2,089.30 Median $2,884.03 Typical High $7,762.47 | Professional | None | $2,089.30 | $2,884.03 | $7,762.47 |
Well Sense Setting Facility Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,630.27 | Facility | None | $1,288.25 | $1,778.28 | $2,630.27 |
Well Sense Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
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 $588.84 Median $588.84 Typical High $2,570.40 | Professional | 52 · Reduced service | $588.84 | $588.84 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $1,047.13 | Professional | 53 · Discontinued | $234.42 | $234.42 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $3,890.45 | Professional | 54 · Surgery only | $870.96 | $870.96 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $776.25 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $524.81 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $3,630.78 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service + 82 · Assistant surgeon, no resident Typical Low $194.98 Median $251.19 Typical High $338.84 | Professional | 52 · Reduced service + 82 · Assistant surgeon, no resident | $194.98 | $251.19 | $338.84 |
Where Massachusetts sits
The same service costs 5.9 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· 19th of 51
$2,630
AK $7,079TX $1,202
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.