How much rates vary
Facilitymedian $347 · 10th to 90th $135 to $3,548Professionalmedian $282 · 10th to 90th $162 to $1,230
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 $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $204.17 | Professional | None | $128.82 | $128.82 | $204.17 |
AllWays Health Partners Setting Facility Modifier None Typical Low $134.90 Median $776.25 Typical High $3,630.78 | Facility | None | $134.90 | $776.25 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $177.83 Median $426.58 Typical High $1,230.27 | Professional | None | $177.83 | $426.58 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $489.78 | Professional | None | $275.42 | $275.42 | $489.78 |
Fallon Health Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $3,311.31 | Facility | None | $186.21 | $229.09 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $275.42 | Professional | None | $194.98 | $229.09 | $275.42 |
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 $204.17 Median $371.54 Typical High $562.34 | Professional | None | $204.17 | $371.54 | $562.34 |
Mass General Brigham Setting Facility Modifier None Typical Low $134.90 Median $776.25 Typical High $3,630.78 | Facility | None | $134.90 | $776.25 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $177.83 Median $426.58 Typical High $1,230.27 | Professional | None | $177.83 | $426.58 | $1,230.27 |
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 $234.42 Median $316.23 Typical High $794.33 | Professional | None | $234.42 | $316.23 | $794.33 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $162.18 Typical High $257.04 | Facility | None | $131.83 | $162.18 | $257.04 |
Well Sense Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | None | $134.90 | $134.90 | $162.18 |
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 $64.57 Median $64.57 Typical High $102.33 | Professional | 52 · Reduced service | $64.57 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $40.74 | Professional | 53 · Discontinued | $25.70 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $151.36 | Professional | 54 · Surgery only | $97.72 | $97.72 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $30.20 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $20.42 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $251.19 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $194.98 | $251.19 | $338.84 |
Where Massachusetts sits
The same service costs 4.3 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
$295
WI $851NY $200
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.