How much rates vary
Facilitymedian $1,950 · 10th to 90th $708 to $5,888Professionalmedian $1,259 · 10th to 90th $692 to $6,310
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 $1,949.84 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $2,187.76 | Professional | None | $660.69 | $660.69 | $2,187.76 |
AllWays Health Partners Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $6,309.57 | Facility | None | $691.83 | $2,137.96 | $6,309.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $812.83 Median $1,737.80 Typical High $6,309.57 | Professional | None | $812.83 | $1,737.80 | $6,309.57 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,621.81 | Professional | None | $758.58 | $758.58 | $1,621.81 |
Fallon Health Setting Facility Modifier None Typical Low $724.44 Median $933.25 Typical High $3,311.31 | Facility | None | $724.44 | $933.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,122.02 | Professional | None | $831.76 | $954.99 | $1,122.02 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $794.33 Median $1,479.11 Typical High $2,238.72 | Professional | None | $794.33 | $1,479.11 | $2,238.72 |
Health New England Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $645.65 | Professional | None | $630.96 | $630.96 | $645.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $6,309.57 | Facility | None | $691.83 | $2,137.96 | $6,309.57 |
Mass General Brigham Setting Professional Modifier None Typical Low $812.83 Median $1,737.80 Typical High $6,309.57 | Professional | None | $812.83 | $1,737.80 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $10,715.19 | Facility | None | $1,071.52 | $3,467.37 | $10,715.19 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $3,235.94 | Professional | None | $891.25 | $1,202.26 | $3,235.94 |
Well Sense Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,258.93 | Facility | None | $602.56 | $1,071.52 | $1,258.93 |
Well Sense Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $741.31 | Professional | None | $549.54 | $549.54 | $741.31 |
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 $331.13 Median $331.13 Typical High $1,096.48 | Professional | 52 · Reduced service | $331.13 | $331.13 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $436.52 | Professional | 53 · Discontinued | $131.83 | $131.83 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $1,659.59 | Professional | 54 · Surgery only | $501.19 | $501.19 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $331.13 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $218.78 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $1,548.82 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $1,023.29 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $602.56 | $1,023.29 | $1,380.38 |
Where Massachusetts sits
The same service costs 4.4 times more in Wisconsin than in Montana. 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
WI $9,724MT $2,195
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.