How much rates vary
Facilitymedian $2,512 · 10th to 90th $407 to $4,365Professionalmedian $4,074 · 10th to 90th $2,344 to $16,596
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 $2,344.23 Median $2,344.23 Typical High $3,630.78 | Professional | None | $2,344.23 | $2,344.23 | $3,630.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,888.44 | Facility | None | $346.74 | $1,047.13 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $16,595.87 | Professional | None | $2,398.83 | $6,309.57 | $16,595.87 |
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 $3,090.30 Median $3,890.45 Typical High $5,888.44 | Professional | None | $3,090.30 | $3,890.45 | $5,888.44 |
Fallon Health Setting Facility Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,715.35 | Facility | None | $2,511.89 | $3,090.30 | $3,715.35 |
Fallon Health Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $4,365.16 | Professional | None | $2,754.23 | $3,235.94 | $4,365.16 |
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 $2,754.23 Median $5,128.61 Typical High $7,079.46 | Professional | None | $2,754.23 | $5,128.61 | $7,079.46 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,888.44 | Facility | None | $346.74 | $1,047.13 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $16,595.87 | Professional | None | $2,398.83 | $6,309.57 | $16,595.87 |
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 $2,454.71 Median $3,311.31 Typical High $10,000.00 | Professional | None | $2,454.71 | $3,311.31 | $10,000.00 |
Well Sense Setting Facility Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $3,715.35 | Facility | None | $1,819.70 | $2,511.89 | $3,715.35 |
Well Sense Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,698.24 | $1,698.24 | $2,290.87 |
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 $1,174.90 Median $1,174.90 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $660.69 | Professional | 53 · Discontinued | $467.74 | $467.74 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $501.19 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $331.13 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $2,344.23 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,691.53 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,548.82 | $2,691.53 | $3,548.13 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $691.83 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $691.83 | $912.01 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $1,096.48 Median $1,096.48 Typical High $1,479.11 | Professional | Q3 · Living kidney donor | $1,096.48 | $1,096.48 | $1,479.11 |
Where Massachusetts sits
The same service costs 21.4 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· 15th of 51
$3,890
AK $8,318TX $389
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.