How much rates vary
Facilitymedian $240 · 10th to 90th $102 to $2,951Professionalmedian $158 · 10th to 90th $89 to $776
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $194.98 | Professional | None | $81.28 | $81.28 | $194.98 |
AllWays Health Partners Setting Facility Modifier None Typical Low $239.88 Median $707.95 Typical High $2,818.38 | Facility | None | $239.88 | $707.95 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $97.72 Median $275.42 Typical High $776.25 | Professional | None | $97.72 | $275.42 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $302.00 | Professional | None | $112.20 | $117.49 | $302.00 |
Fallon Health Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $3,311.31 | Facility | None | $102.33 | $125.89 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $177.83 | Professional | None | $107.15 | $128.82 | $177.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $354.81 | Professional | None | $112.20 | $190.55 | $354.81 |
Health New England Setting Facility Modifier None Typical Low $346.74 Median $691.83 Typical High $2,041.74 | Facility | None | $346.74 | $691.83 | $2,041.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $239.88 Median $707.95 Typical High $2,818.38 | Facility | None | $239.88 | $707.95 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $97.72 Median $275.42 Typical High $776.25 | Professional | None | $97.72 | $275.42 | $776.25 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,737.80 Typical High $2,818.38 | Facility | None | $660.69 | $1,737.80 | $2,818.38 |
United Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $354.81 | Professional | None | $104.71 | $147.91 | $354.81 |
Well Sense Setting Facility Modifier None Typical Low $77.62 Median $107.15 Typical High $158.49 | Facility | None | $77.62 | $107.15 | $158.49 |
Well Sense Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | None | $81.28 | $81.28 | $97.72 |
6 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 $40.74 Median $40.74 Typical High $57.54 | Professional | 52 · Reduced service | $40.74 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $22.91 | Professional | 53 · Discontinued | $16.22 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | 54 · Surgery only | $60.26 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $17.38 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $11.48 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon + 82 · Assistant surgeon, no resident Typical Low $16.22 Median $27.54 Typical High $27.54 | Professional | 80 · Assistant surgeon + 82 · Assistant surgeon, no resident | $16.22 | $27.54 | $27.54 |
Where Massachusetts sits
The same service costs 3.5 times more in Wisconsin than in New York. 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· 17th of 51
$158
WI $316NY $89.13
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.