How much rates vary
Facilitymedian $2,042 · 10th to 90th $407 to $4,074Professionalmedian $3,090 · 10th to 90th $1,778 to $20,417
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 $1,318.26 Median $1,318.26 Typical High $3,311.31 | Professional | None | $1,318.26 | $1,318.26 | $3,311.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,786.30 | Facility | None | $346.74 | $1,047.13 | $4,786.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,995.26 Median $4,897.79 Typical High $20,417.38 | Professional | None | $1,995.26 | $4,897.79 | $20,417.38 |
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 $3,019.95 Median $3,019.95 Typical High $5,370.32 | Professional | None | $3,019.95 | $3,019.95 | $5,370.32 |
Fallon Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,548.13 | Facility | None | $2,041.74 | $2,511.89 | $3,548.13 |
Fallon Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,511.89 | $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 $4,786.30 | Facility | None | $346.74 | $1,047.13 | $4,786.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,995.26 Median $4,897.79 Typical High $20,417.38 | Professional | None | $1,995.26 | $4,897.79 | $20,417.38 |
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 $2,290.87 Median $3,162.28 Typical High $8,709.64 | Professional | None | $2,290.87 | $3,162.28 | $8,709.64 |
Well Sense Setting Facility Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $2,951.21 | Facility | None | $1,445.44 | $1,995.26 | $2,951.21 |
Well Sense Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,479.11 | $1,778.28 |
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 $660.69 Median $660.69 Typical High $2,818.38 | Professional | 52 · Reduced service | $660.69 | $660.69 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $1,148.15 | Professional | 53 · Discontinued | $263.03 | $263.03 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $4,265.80 | Professional | 54 · Surgery only | $977.24 | $977.24 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $851.14 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $575.44 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $3,981.07 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $6,309.57 | $6,309.57 | $6,309.57 |
Where Massachusetts sits
The same service costs 5.8 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
$2,951
AK $7,943TX $1,380
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.