How much rates vary
Facilitymedian $977 · 10th to 90th $347 to $3,548Professionalmedian $1,230 · 10th to 90th $724 to $5,495
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 $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $933.25 | Professional | None | $575.44 | $575.44 | $933.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $794.33 Typical High $3,630.78 | Facility | None | $316.23 | $794.33 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $794.33 Median $1,905.46 Typical High $5,495.41 | Professional | None | $794.33 | $1,905.46 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,230.27 | $2,187.76 |
Fallon Health Setting Facility Modifier None Typical Low $831.76 Median $1,023.29 Typical High $3,311.31 | Facility | None | $831.76 | $1,023.29 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,230.27 | Professional | None | $870.96 | $1,023.29 | $1,230.27 |
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 $912.01 Median $1,659.59 Typical High $2,511.89 | Professional | None | $912.01 | $1,659.59 | $2,511.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $794.33 Typical High $3,630.78 | Facility | None | $316.23 | $794.33 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $794.33 Median $1,905.46 Typical High $5,495.41 | Professional | None | $794.33 | $1,905.46 | $5,495.41 |
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 $1,047.13 Median $1,412.54 Typical High $3,548.13 | Professional | None | $1,047.13 | $1,412.54 | $3,548.13 |
Well Sense Setting Facility Modifier None Typical Low $588.84 Median $724.44 Typical High $1,148.15 | Facility | None | $588.84 | $724.44 | $1,148.15 |
Well Sense Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | None | $602.56 | $602.56 | $724.44 |
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 $288.40 Median $288.40 Typical High $457.09 | Professional | 52 · Reduced service | $288.40 | $288.40 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $181.97 | Professional | 53 · Discontinued | $117.49 | $117.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $676.08 | Professional | 54 · Surgery only | $436.52 | $436.52 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $138.04 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $91.20 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $91.20 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,122.02 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $851.14 | $1,122.02 | $1,479.11 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $223.87 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $223.87 | $346.74 |
Where Massachusetts sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 27th of 51
$1,202
AK $3,236KY $759
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.