How much rates vary
Facilitymedian $1,778 · 10th to 90th $407 to $3,715Professionalmedian $2,692 · 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 $2,290.87 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,290.87 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,513.56 | $2,238.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,073.80 | Facility | None | $346.74 | $1,047.13 | $4,073.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,659.59 Median $4,168.69 Typical High $12,589.25 | Professional | None | $1,659.59 | $4,168.69 | $12,589.25 |
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 $2,089.30 Median $2,511.89 Typical High $3,801.89 | Professional | None | $2,089.30 | $2,511.89 | $3,801.89 |
Fallon Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $3,311.31 | Facility | None | $1,659.59 | $2,041.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,819.70 | $2,137.96 | $2,884.03 |
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 $1,819.70 Median $3,388.44 Typical High $4,677.35 | Professional | None | $1,819.70 | $3,388.44 | $4,677.35 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,073.80 | Facility | None | $346.74 | $1,047.13 | $4,073.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,659.59 Median $4,168.69 Typical High $12,589.25 | Professional | None | $1,659.59 | $4,168.69 | $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 $1,621.81 Median $2,187.76 Typical High $6,606.93 | Professional | None | $1,621.81 | $2,187.76 | $6,606.93 |
Well Sense Setting Facility Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $2,398.83 | Facility | None | $1,174.90 | $1,621.81 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,096.48 | $1,479.11 |
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 $758.58 Median $758.58 Typical High $1,071.52 | Professional | 52 · Reduced service | $758.58 | $758.58 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $436.52 | Professional | 53 · Discontinued | $302.00 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $323.59 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $218.78 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,513.56 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $446.68 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $446.68 | $602.56 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $954.99 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $758.58 Median $758.58 Typical High $1,023.29 | Professional | Q3 · Living kidney donor | $758.58 | $758.58 | $1,023.29 |
Where Massachusetts sits
The same service costs 20.9 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
$2,512
AK $5,370TX $257
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.