How much rates vary
Facilitymedian $1,905 · 10th to 90th $407 to $4,074Professionalmedian $2,818 · 10th to 90th $1,660 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 $4,466.84 | Facility | None | $346.74 | $1,047.13 | $4,466.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,819.70 Median $4,466.84 Typical High $19,498.45 | Professional | None | $1,819.70 | $4,466.84 | $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 $2,818.38 Median $2,818.38 Typical High $5,011.87 | Professional | None | $2,818.38 | $2,818.38 | $5,011.87 |
Fallon Health Setting Facility Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,311.31 | Facility | None | $1,905.46 | $2,344.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,344.23 | $2,818.38 |
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 $2,089.30 Median $3,801.89 Typical High $5,754.40 | Professional | None | $2,089.30 | $3,801.89 | $5,754.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,466.84 | Facility | None | $346.74 | $1,047.13 | $4,466.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,819.70 Median $4,466.84 Typical High $19,498.45 | Professional | None | $1,819.70 | $4,466.84 | $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 $2,089.30 Median $2,951.21 Typical High $8,128.31 | Professional | None | $2,089.30 | $2,951.21 | $8,128.31 |
Well Sense Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,754.23 | Facility | None | $1,348.96 | $1,862.09 | $2,754.23 |
Well Sense Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,412.54 | $1,698.24 |
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 $2,691.53 | Professional | 52 · Reduced service | $616.60 | $616.60 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $1,096.48 | Professional | 53 · Discontinued | $245.47 | $245.47 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $4,073.80 | Professional | 54 · Surgery only | $912.01 | $912.01 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $812.83 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $812.83 |
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 $851.14 Median $851.14 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $3,801.89 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service + 82 · Assistant surgeon, no resident Typical Low $199.53 Median $257.04 Typical High $346.74 | Professional | 52 · Reduced service + 82 · Assistant surgeon, no resident | $199.53 | $257.04 | $346.74 |
Where Massachusetts sits
The same service costs 6.0 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
$2,754
AK $7,413TX $1,230
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.