How much rates vary
Facilitymedian $1,660 · 10th to 90th $741 to $5,248Professionalmedian $1,995 · 10th to 90th $1,023 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 $1,445.44 Median $1,445.44 Typical High $4,365.16 | Professional | None | $1,445.44 | $1,445.44 | $4,365.16 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $5,623.41 | Facility | None | $724.44 | $2,187.76 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,348.96 Median $3,715.35 Typical High $12,589.25 | Professional | None | $1,348.96 | $3,715.35 | $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 $1,862.09 Median $1,862.09 Typical High $4,677.35 | Professional | None | $1,862.09 | $1,862.09 | $4,677.35 |
Fallon Health Setting Facility Modifier None Typical Low $776.25 Median $1,513.56 Typical High $2,398.83 | Facility | None | $776.25 | $1,513.56 | $2,398.83 |
Fallon Health Setting Professional Modifier None Typical Low $776.25 Median $1,380.38 Typical High $1,995.26 | Professional | None | $776.25 | $1,380.38 | $1,995.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $4,073.80 | Professional | None | $1,513.56 | $2,630.27 | $4,073.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $5,623.41 | Facility | None | $724.44 | $2,187.76 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,348.96 Median $3,715.35 Typical High $12,589.25 | Professional | None | $1,348.96 | $3,715.35 | $12,589.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $7,244.36 | Facility | None | $851.14 | $2,818.38 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $6,165.95 | Professional | None | $1,513.56 | $2,041.74 | $6,165.95 |
Well Sense Setting Facility Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $2,089.30 | Facility | None | $1,023.29 | $1,412.54 | $2,089.30 |
Well Sense Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,096.48 | $1,288.25 |
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 $724.44 Median $724.44 Typical High $2,187.76 | Professional | 52 · Reduced service | $724.44 | $724.44 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $870.96 | Professional | 53 · Discontinued | $288.40 | $288.40 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $660.69 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $436.52 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $3,090.30 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $380.19 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $380.19 | $501.19 |
Where Massachusetts sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 26th of 51
$1,950
AK $5,623UT $977
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.