How much rates vary
Facilitymedian $3,311 · 10th to 90th $407 to $6,310Professionalmedian $7,079 · 10th to 90th $4,074 to $28,840
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 $3,388.44 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,388.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,754.40 | Professional | None | $4,073.80 | $4,073.80 | $5,754.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $9,772.37 | Facility | None | $346.74 | $1,047.13 | $9,772.37 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4,466.84 Median $10,964.78 Typical High $28,840.32 | Professional | None | $4,466.84 | $10,964.78 | $28,840.32 |
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 $5,495.41 Median $6,760.83 Typical High $10,232.93 | Professional | None | $5,495.41 | $6,760.83 | $10,232.93 |
Fallon Health Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $6,309.57 | Facility | None | $3,311.31 | $5,370.32 | $6,309.57 |
Fallon Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $7,585.78 | Professional | None | $4,786.30 | $5,623.41 | $7,585.78 |
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 $4,786.30 Median $9,120.11 Typical High $12,589.25 | Professional | None | $4,786.30 | $9,120.11 | $12,589.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $9,772.37 | Facility | None | $346.74 | $1,047.13 | $9,772.37 |
Mass General Brigham Setting Professional Modifier None Typical Low $4,466.84 Median $10,964.78 Typical High $28,840.32 | Professional | None | $4,466.84 | $10,964.78 | $28,840.32 |
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 $4,365.16 Median $5,754.40 Typical High $17,782.79 | Professional | None | $4,365.16 | $5,754.40 | $17,782.79 |
Well Sense Setting Facility Modifier None Typical Low $3,090.30 Median $4,168.69 Typical High $6,456.54 | Facility | None | $3,090.30 | $4,168.69 | $6,456.54 |
Well Sense Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,818.38 | $2,818.38 | $3,801.89 |
7 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 $2,041.74 Median $2,041.74 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $1,148.15 | Professional | 53 · Discontinued | $812.83 | $812.83 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,090.30 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,090.30 | $3,090.30 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | 55 · Aftercare only | $616.60 | $616.60 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $575.44 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $2,884.03 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $2,884.03 | $2,884.03 | $3,981.07 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $707.95 Median $1,202.26 Typical High $1,258.93 | Professional | 82 · Assistant surgeon, no resident | $707.95 | $1,202.26 | $1,258.93 |
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· 13th of 51
$6,761
AK $14,125TX $676
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.