How much rates vary
Facilitymedian $537 · 10th to 90th $234 to $3,548Professionalmedian $437 · 10th to 90th $257 to $14,791
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 $831.76 Median $2,818.38 Typical High $5,128.61 | Facility | None | $831.76 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $467.74 | Professional | None | $186.21 | $186.21 | $467.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $204.17 Median $724.44 Typical High $3,548.13 | Facility | None | $204.17 | $724.44 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $269.15 Median $660.69 Typical High $14,791.08 | Professional | None | $269.15 | $660.69 | $14,791.08 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $602.56 | Professional | None | $275.42 | $446.68 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,380.38 Typical High $1,380.38 | Facility | None | $676.08 | $1,380.38 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $758.58 | Professional | None | $426.58 | $426.58 | $758.58 |
Fallon Health Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $3,311.31 | Facility | None | $281.84 | $346.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $416.87 | Professional | None | $295.12 | $346.74 | $416.87 |
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 $309.03 Median $562.34 Typical High $870.96 | Professional | None | $309.03 | $562.34 | $870.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $204.17 Median $724.44 Typical High $3,548.13 | Facility | None | $204.17 | $724.44 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $269.15 Median $660.69 Typical High $14,791.08 | Professional | None | $269.15 | $660.69 | $14,791.08 |
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 $338.84 Median $457.09 Typical High $1,230.27 | Professional | None | $338.84 | $457.09 | $1,230.27 |
Well Sense Setting Facility Modifier None Typical Low $199.53 Median $281.84 Typical High $416.87 | Facility | None | $199.53 | $281.84 | $416.87 |
Well Sense Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | None | $213.80 | $213.80 | $257.04 |
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 $91.20 Median $91.20 Typical High $416.87 | Professional | 52 · Reduced service | $91.20 | $91.20 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $165.96 | Professional | 53 · Discontinued | $37.15 | $37.15 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $630.96 | Professional | 54 · Surgery only | $138.04 | $138.04 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $125.89 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $83.18 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $58.88 Median $75.86 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $58.88 | $75.86 | $102.33 |
Where Massachusetts sits
The same service costs 3.9 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· 33rd of 51
$437
WI $1,175NY $302
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.