How much rates vary
Facilitymedian $525 · 10th to 90th $257 to $3,548Professionalmedian $646 · 10th to 90th $331 to $16,218
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 $660.69 Median $660.69 Typical High $758.58 | Professional | None | $660.69 | $660.69 | $758.58 |
AllWays Health Partners Setting Facility Modifier None Typical Low $251.19 Median $776.25 Typical High $3,548.13 | Facility | None | $251.19 | $776.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $331.13 Median $812.83 Typical High $16,218.10 | Professional | None | $331.13 | $812.83 | $16,218.10 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $630.96 | Professional | None | $371.54 | $371.54 | $630.96 |
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 $645.65 Median $645.65 Typical High $1,047.13 | Professional | None | $645.65 | $645.65 | $1,047.13 |
Fallon Health Setting Facility Modifier None Typical Low $363.08 Median $446.68 Typical High $3,311.31 | Facility | None | $363.08 | $446.68 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $588.84 | Professional | None | $380.19 | $446.68 | $588.84 |
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 $331.13 Median $616.60 Typical High $891.25 | Professional | None | $331.13 | $616.60 | $891.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $251.19 Median $776.25 Typical High $3,548.13 | Facility | None | $251.19 | $776.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $331.13 Median $812.83 Typical High $16,218.10 | Professional | None | $331.13 | $812.83 | $16,218.10 |
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 $316.23 Median $446.68 Typical High $1,318.26 | Professional | None | $316.23 | $446.68 | $1,318.26 |
Well Sense Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $457.09 | Facility | None | $257.04 | $331.13 | $457.09 |
Well Sense Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,995.26 | $1,995.26 | $2,691.53 |
4 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 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $58.88 Median $100.00 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $58.88 | $100.00 | $134.90 |
Where Massachusetts sits
The same service costs 15.1 times more in New York than in Hawaii. 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· 12th of 51
$646
NY $3,802HI $251
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.