How much rates vary
Facilitymedian $1,950 · 10th to 90th $407 to $4,074Professionalmedian $2,951 · 10th to 90th $1,698 to $19,498
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 $5,495.41 | Facility | None | $2,691.53 | $3,090.30 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $5,495.41 | Professional | None | $1,230.27 | $1,230.27 | $5,495.41 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,570.88 | Facility | None | $346.74 | $1,047.13 | $4,570.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,862.09 Median $4,570.88 Typical High $19,498.45 | Professional | None | $1,862.09 | $4,570.88 | $19,498.45 |
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 $2,884.03 Median $2,884.03 Typical High $5,128.61 | Professional | None | $2,884.03 | $2,884.03 | $5,128.61 |
Fallon Health Setting Facility Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,388.44 | Facility | None | $1,949.84 | $2,398.83 | $3,388.44 |
Fallon Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,398.83 | $2,884.03 |
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 $2,137.96 Median $3,890.45 Typical High $5,888.44 | Professional | None | $2,137.96 | $3,890.45 | $5,888.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,570.88 | Facility | None | $346.74 | $1,047.13 | $4,570.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,862.09 Median $4,570.88 Typical High $19,498.45 | Professional | None | $1,862.09 | $4,570.88 | $19,498.45 |
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 $2,137.96 Median $3,019.95 Typical High $8,317.64 | Professional | None | $2,137.96 | $3,019.95 | $8,317.64 |
Well Sense Setting Facility Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,818.38 | Facility | None | $1,380.38 | $1,905.46 | $2,818.38 |
Well Sense Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,513.56 | $1,819.70 |
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 $616.60 Median $616.60 Typical High $2,754.23 | Professional | 52 · Reduced service | $616.60 | $616.60 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $1,122.02 | Professional | 53 · Discontinued | $251.19 | $251.19 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $4,168.69 | Professional | 54 · Surgery only | $933.25 | $933.25 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $831.76 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $549.54 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $3,890.45 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service + 82 · Assistant surgeon, no resident Typical Low $204.17 Median $263.03 Typical High $354.81 | Professional | 52 · Reduced service + 82 · Assistant surgeon, no resident | $204.17 | $263.03 | $354.81 |
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
$2,818
AK $7,586TX $1,288
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.