How much rates vary
Facilitymedian $1,862 · 10th to 90th $407 to $3,981Professionalmedian $2,884 · 10th to 90th $1,698 to $11,749
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 $1,698.24 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,698.24 | $1,698.24 | $2,454.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,365.16 | Facility | None | $346.74 | $1,047.13 | $4,365.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $11,748.98 | Professional | None | $1,698.24 | $4,570.88 | $11,748.98 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $4,073.80 | Professional | None | $1,778.28 | $2,754.23 | $4,073.80 |
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 $2,137.96 Median $2,754.23 Typical High $4,168.69 | Professional | None | $2,137.96 | $2,754.23 | $4,168.69 |
Fallon Health Setting Facility Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,311.31 | Facility | None | $1,778.28 | $2,187.76 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,995.26 | $2,344.23 | $3,162.28 |
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 $1,995.26 Median $3,715.35 Typical High $5,128.61 | Professional | None | $1,995.26 | $3,715.35 | $5,128.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,365.16 | Facility | None | $346.74 | $1,047.13 | $4,365.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $11,748.98 | Professional | None | $1,698.24 | $4,570.88 | $11,748.98 |
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 $2,398.83 Typical High $6,760.83 | Professional | None | $1,698.24 | $2,398.83 | $6,760.83 |
Well Sense Setting Facility Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,630.27 | Facility | None | $1,288.25 | $1,778.28 | $2,630.27 |
Well Sense Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,230.27 | $1,659.59 |
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 $851.14 Median $851.14 Typical High $1,202.26 | Professional | 52 · Reduced service | $851.14 | $851.14 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $478.63 | Professional | 53 · Discontinued | $338.84 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $239.88 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,659.59 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $2,454.71 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $1,445.44 | $2,454.71 | $3,311.31 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $489.78 Typical High $660.69 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $489.78 | $660.69 |
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 $707.95 Median $707.95 Typical High $954.99 | Professional | Q3 · Living kidney donor | $707.95 | $707.95 | $954.99 |
Where Massachusetts sits
The same service costs 7.6 times more in Maine than in Maryland. 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 $18,140MD $2,382
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.