How much rates vary
Facilitymedian $1,698 · 10th to 90th $407 to $3,715Professionalmedian $2,754 · 10th to 90th $1,514 to $12,589
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 $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,513.56 | $1,513.56 | $2,398.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,981.07 | Facility | None | $346.74 | $1,047.13 | $3,981.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,737.80 Median $4,073.80 Typical High $12,589.25 | Professional | None | $1,737.80 | $4,073.80 | $12,589.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,398.83 | $3,630.78 |
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 $2,187.76 Median $2,398.83 Typical High $3,715.35 | Professional | None | $2,187.76 | $2,398.83 | $3,715.35 |
Fallon Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $3,311.31 | Facility | None | $1,621.81 | $1,995.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,778.28 | $2,089.30 | $2,818.38 |
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 $1,778.28 Median $3,388.44 Typical High $4,677.35 | Professional | None | $1,778.28 | $3,388.44 | $4,677.35 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,981.07 | Facility | None | $346.74 | $1,047.13 | $3,981.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,737.80 Median $4,073.80 Typical High $12,589.25 | Professional | None | $1,737.80 | $4,073.80 | $12,589.25 |
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 $1,698.24 Median $2,344.23 Typical High $6,456.54 | Professional | None | $1,698.24 | $2,344.23 | $6,456.54 |
Well Sense Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,344.23 | Facility | None | $1,148.15 | $1,548.82 | $2,344.23 |
Well Sense Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,202.26 | $1,621.81 |
10 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 $758.58 Median $758.58 Typical High $1,047.13 | Professional | 52 · Reduced service | $758.58 | $758.58 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $416.87 | Professional | 53 · Discontinued | $302.00 | $302.00 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $208.93 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,479.11 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,737.80 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,000.00 | $1,737.80 | $2,290.87 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $436.52 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $436.52 | $588.84 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,047.13 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | Q3 · Living kidney donor | $977.24 | $977.24 | $1,318.26 |
Where Massachusetts sits
The same service costs 5.4 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· 14th of 51
$2,570
AK $5,623TX $1,047
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.