How much rates vary
Facilitymedian $1,820 · 10th to 90th $724 to $5,623Professionalmedian $1,445 · 10th to 90th $851 to $6,607
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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $2,454.71 | Professional | None | $776.25 | $776.25 | $2,454.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $5,754.40 | Facility | None | $549.54 | $2,137.96 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $977.24 Median $2,187.76 Typical High $6,606.93 | Professional | None | $977.24 | $2,187.76 | $6,606.93 |
Fallon Health Setting Facility Modifier None Typical Low $870.96 Median $1,202.26 Typical High $3,311.31 | Facility | None | $870.96 | $1,202.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,258.93 | $1,445.44 |
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 $1,000.00 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,000.00 | $1,862.09 | $2,818.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $5,754.40 | Facility | None | $549.54 | $2,137.96 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $977.24 Median $2,187.76 Typical High $6,606.93 | Professional | None | $977.24 | $2,187.76 | $6,606.93 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $3,981.07 | Professional | None | $1,000.00 | $1,380.38 | $3,981.07 |
Well Sense Setting Facility Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,412.54 | Facility | None | $724.44 | $1,023.29 | $1,412.54 |
Well Sense Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $812.83 | Professional | None | $602.56 | $602.56 | $812.83 |
8 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 $389.05 Median $389.05 Typical High $1,202.26 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $489.78 | Professional | 53 · Discontinued | $158.49 | $158.49 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $1,819.70 | Professional | 54 · Surgery only | $588.84 | $588.84 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $363.08 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $245.47 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $1,698.24 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,318.26 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $776.25 | $1,318.26 | $1,778.28 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $263.03 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $263.03 | $354.81 |
Where Massachusetts sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.