How much rates vary
Facilitymedian $617 · 10th to 90th $331 to $3,548Professionalmedian $708 · 10th to 90th $407 to $3,090
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 $331.13 Median $331.13 Typical High $512.86 | Professional | None | $331.13 | $331.13 | $512.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $794.33 Typical High $3,630.78 | Facility | None | $316.23 | $794.33 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,090.30 | Professional | None | $446.68 | $1,096.48 | $3,090.30 |
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 $691.83 Median $691.83 Typical High $1,230.27 | Professional | None | $691.83 | $691.83 | $1,230.27 |
Fallon Health Setting Facility Modifier None Typical Low $467.74 Median $575.44 Typical High $3,311.31 | Facility | None | $467.74 | $575.44 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $691.83 | Professional | None | $489.78 | $575.44 | $691.83 |
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 $512.86 Median $933.25 Typical High $1,445.44 | Professional | None | $512.86 | $933.25 | $1,445.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $794.33 Typical High $3,630.78 | Facility | None | $316.23 | $794.33 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,090.30 | Professional | None | $446.68 | $1,096.48 | $3,090.30 |
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 $588.84 Median $794.33 Typical High $1,995.26 | Professional | None | $588.84 | $794.33 | $1,995.26 |
Well Sense Setting Facility Modifier None Typical Low $331.13 Median $416.87 Typical High $645.65 | Facility | None | $331.13 | $416.87 | $645.65 |
Well Sense Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | None | $346.74 | $346.74 | $407.38 |
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 $162.18 Median $162.18 Typical High $257.04 | Professional | 52 · Reduced service | $162.18 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 53 · Discontinued | $66.07 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $245.47 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $51.29 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $51.29 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $630.96 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $489.78 | $630.96 | $851.14 |
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
$692
WI $1,905NY $490
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.