How much rates vary
Facilitymedian $407 · 10th to 90th $174 to $3,548Professionalmedian $347 · 10th to 90th $204 to $1,549
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 $151.36 Median $151.36 Typical High $257.04 | Professional | None | $151.36 | $151.36 | $257.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $173.78 Median $776.25 Typical High $3,630.78 | Facility | None | $173.78 | $776.25 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $223.87 Median $549.54 Typical High $1,548.82 | Professional | None | $223.87 | $549.54 | $1,548.82 |
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 $346.74 Median $346.74 Typical High $616.60 | Professional | None | $346.74 | $346.74 | $616.60 |
Fallon Health Setting Facility Modifier None Typical Low $234.42 Median $295.12 Typical High $3,311.31 | Facility | None | $234.42 | $295.12 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $354.81 | Professional | None | $251.19 | $288.40 | $354.81 |
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 $263.03 Median $478.63 Typical High $724.44 | Professional | None | $263.03 | $478.63 | $724.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $173.78 Median $776.25 Typical High $3,630.78 | Facility | None | $173.78 | $776.25 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $223.87 Median $549.54 Typical High $1,548.82 | Professional | None | $223.87 | $549.54 | $1,548.82 |
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 $281.84 Median $371.54 Typical High $1,000.00 | Professional | None | $281.84 | $371.54 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $158.49 Median $204.17 Typical High $323.59 | Facility | None | $158.49 | $204.17 | $323.59 |
Well Sense Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | None | $158.49 | $158.49 | $190.55 |
5 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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR + 82 · Assistant surgeon, no resident Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 78 · Unplanned return to OR + 82 · Assistant surgeon, no resident | $114.82 | $114.82 | $114.82 |
Where Massachusetts sits
The same service costs 4.1 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· 34th of 51
$347
WI $1,000NY $245
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.