How much rates vary
Facilitymedian $2,399 · 10th to 90th $832 to $5,129Professionalmedian $3,631 · 10th to 90th $2,188 to $14,125
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 $2,187.76 Median $2,187.76 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,187.76 | $3,162.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $1,698.24 Typical High $5,370.32 | Facility | None | $724.44 | $1,698.24 | $5,370.32 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,089.30 Median $5,495.41 Typical High $14,125.38 | Professional | None | $2,089.30 | $5,495.41 | $14,125.38 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $2,754.23 Median $2,754.23 Typical High $5,248.07 | Professional | None | $2,754.23 | $2,754.23 | $5,248.07 |
Fallon Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $3,630.78 | Facility | None | $2,137.96 | $2,691.53 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,398.83 | $2,818.38 | $3,801.89 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,290.87 Median $4,365.16 Typical High $6,309.57 | Professional | None | $2,290.87 | $4,365.16 | $6,309.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $1,698.24 Typical High $5,370.32 | Facility | None | $724.44 | $1,698.24 | $5,370.32 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,089.30 Median $5,495.41 Typical High $14,125.38 | Professional | None | $2,089.30 | $5,495.41 | $14,125.38 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $5,754.40 | Facility | None | $1,047.13 | $2,344.23 | $5,754.40 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $8,709.64 | Professional | None | $2,187.76 | $2,951.21 | $8,709.64 |
Well Sense Setting Facility Modifier None Typical Low $1,621.81 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,621.81 | $2,238.72 | $3,388.44 |
Well Sense Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,584.89 | $2,137.96 |
9 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 $1,071.52 Median $1,071.52 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $602.56 | Professional | 53 · Discontinued | $436.52 | $436.52 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $457.09 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $2,137.96 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $602.56 Typical High $794.33 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $602.56 | $794.33 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,348.96 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | Q3 · Living kidney donor | $831.76 | $831.76 | $1,122.02 |
Where Massachusetts sits
The same service costs 9.3 times more in Maine than in Delaware. 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.
Physician feeFacility fee
ME $29,670DE $3,198
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.