How much rates vary
Facilitymedian $3,631 · 10th to 90th $407 to $7,079Professionalmedian $7,413 · 10th to 90th $3,715 to $169,824
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 $3,630.78 Median $3,630.78 Typical High $8,912.51 | Professional | None | $3,630.78 | $3,630.78 | $8,912.51 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $10,715.19 | Facility | None | $346.74 | $1,047.13 | $10,715.19 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4,265.80 Median $12,302.69 Typical High $169,824.37 | Professional | None | $4,265.80 | $12,302.69 | $169,824.37 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $4,897.79 Median $7,413.10 Typical High $10,964.78 | Professional | None | $4,897.79 | $7,413.10 | $10,964.78 |
Fallon Health Setting Facility Modifier None Typical Low $3,311.31 Median $5,888.44 Typical High $7,079.46 | Facility | None | $3,311.31 | $5,888.44 | $7,079.46 |
Fallon Health Setting Professional Modifier None Typical Low $5,128.61 Median $6,165.95 Typical High $7,585.78 | Professional | None | $5,128.61 | $6,165.95 | $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 $5,248.07 Median $9,772.37 Typical High $14,454.40 | Professional | None | $5,248.07 | $9,772.37 | $14,454.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $10,715.19 | Facility | None | $346.74 | $1,047.13 | $10,715.19 |
Mass General Brigham Setting Professional Modifier None Typical Low $4,265.80 Median $12,302.69 Typical High $169,824.37 | Professional | None | $4,265.80 | $12,302.69 | $169,824.37 |
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 $4,466.84 Median $6,456.54 Typical High $19,054.61 | Professional | None | $4,466.84 | $6,456.54 | $19,054.61 |
Well Sense Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $7,079.46 | Facility | None | $3,467.37 | $4,677.35 | $7,079.46 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $1,819.70 Median $1,819.70 Typical High $4,897.79 | Professional | 52 · Reduced service | $1,819.70 | $1,819.70 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $724.44 Typical High $1,949.84 | Professional | 53 · Discontinued | $724.44 | $724.44 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $7,413.10 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $549.54 Typical High $1,479.11 | Professional | 55 · Aftercare only | $549.54 | $549.54 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $363.08 Typical High $977.24 | Professional | 56 · Pre-op care only | $363.08 | $363.08 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $6,918.31 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $3,019.95 Median $5,248.07 Typical High $6,918.31 | Professional | 62 · Two surgeons | $3,019.95 | $5,248.07 | $6,918.31 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,890.45 Median $6,606.93 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $3,890.45 | $6,606.93 | $8,912.51 |
Where Massachusetts sits
The same service costs 8.4 times more in Wisconsin 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.
Physician feeFacility fee
WI $28,671TX $3,407
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.