How much rates vary
Facilitymedian $2,089 · 10th to 90th $407 to $4,074Professionalmedian $3,090 · 10th to 90th $1,820 to $21,878
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 $1,380.38 Median $1,380.38 Typical High $3,388.44 | Professional | None | $1,380.38 | $1,380.38 | $3,388.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,897.79 | Facility | None | $346.74 | $1,047.13 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,995.26 Median $4,897.79 Typical High $21,877.62 | Professional | None | $1,995.26 | $4,897.79 | $21,877.62 |
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 $3,090.30 Median $3,090.30 Typical High $5,495.41 | Professional | None | $3,090.30 | $3,090.30 | $5,495.41 |
Fallon Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,630.78 | Facility | None | $2,089.30 | $2,570.40 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,570.40 | $3,090.30 |
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 $2,290.87 Median $4,168.69 Typical High $6,309.57 | Professional | None | $2,290.87 | $4,168.69 | $6,309.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,897.79 | Facility | None | $346.74 | $1,047.13 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,995.26 Median $4,897.79 Typical High $21,877.62 | Professional | None | $1,995.26 | $4,897.79 | $21,877.62 |
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 $2,454.71 Median $3,311.31 Typical High $8,912.51 | Professional | None | $2,454.71 | $3,311.31 | $8,912.51 |
Well Sense Setting Facility Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,019.95 | Facility | None | $1,479.11 | $1,995.26 | $3,019.95 |
Well Sense Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,584.89 | $1,905.46 |
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 $691.83 Median $691.83 Typical High $3,162.28 | Professional | 52 · Reduced service | $691.83 | $691.83 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,258.93 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $933.25 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $630.96 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $4,365.16 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service + 82 · Assistant surgeon, no resident Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service + 82 · Assistant surgeon, no resident | $630.96 | $630.96 | $630.96 |
Where Massachusetts sits
The same service costs 5.2 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· 20th of 51
$3,020
AK $8,128TX $1,549
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.