How much rates vary
Facilitymedian $2,239 · 10th to 90th $407 to $4,074Professionalmedian $3,388 · 10th to 90th $1,995 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 $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $3,981.07 | Professional | None | $1,479.11 | $1,479.11 | $3,981.07 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,370.32 | Facility | None | $346.74 | $1,047.13 | $5,370.32 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,187.76 Median $5,370.32 Typical High $23,442.29 | Professional | None | $2,187.76 | $5,370.32 | $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 $3,388.44 Median $3,388.44 Typical High $6,025.60 | Professional | None | $3,388.44 | $3,388.44 | $6,025.60 |
Fallon Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $3,630.78 | Facility | None | $2,290.87 | $2,818.38 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,818.38 | $3,467.37 |
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 $2,570.40 Median $4,677.35 Typical High $7,079.46 | Professional | None | $2,570.40 | $4,677.35 | $7,079.46 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,370.32 | Facility | None | $346.74 | $1,047.13 | $5,370.32 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,187.76 Median $5,370.32 Typical High $23,442.29 | Professional | None | $2,187.76 | $5,370.32 | $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 $2,691.53 Median $3,630.78 Typical High $9,772.37 | Professional | None | $2,691.53 | $3,630.78 | $9,772.37 |
Well Sense Setting Facility Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $3,311.31 | Facility | None | $1,621.81 | $2,187.76 | $3,311.31 |
Well Sense Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,621.81 | $1,949.84 |
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 $741.31 Median $741.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $1,348.96 | Professional | 53 · Discontinued | $295.12 | $295.12 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $5,011.87 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $1,000.00 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $676.08 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $4,677.35 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service + 82 · Assistant surgeon, no resident Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service + 82 · Assistant surgeon, no resident | $707.95 | $707.95 | $707.95 |
Where Massachusetts sits
The same service costs 6.2 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· 19th of 51
$3,311
AK $9,120TX $1,479
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.