How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,000 to $7,244Professionalmedian $1,950 · 10th to 90th $1,096 to $7,413
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 $1,949.84 Median $3,162.28 Typical High $8,709.64 | Facility | None | $1,949.84 | $3,162.28 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,096.48 | $1,778.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $954.99 Median $2,951.21 Typical High $7,943.28 | Facility | None | $954.99 | $2,951.21 | $7,943.28 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,174.90 Median $2,818.38 Typical High $7,413.10 | Professional | None | $1,174.90 | $2,818.38 | $7,413.10 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,122.02 | $2,454.71 |
Fallon Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $3,311.31 | Facility | None | $1,122.02 | $1,412.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,445.44 | $1,995.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $870.96 Median $3,630.78 Typical High $10,232.93 | Facility | None | $870.96 | $3,630.78 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,174.90 | $2,344.23 | $3,467.37 |
Health New England Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,000.00 | $2,089.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $954.99 Median $2,951.21 Typical High $7,943.28 | Facility | None | $954.99 | $2,951.21 | $7,943.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,174.90 Median $2,818.38 Typical High $7,413.10 | Professional | None | $1,174.90 | $2,818.38 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,715.35 Typical High $13,489.63 | Facility | None | $1,096.48 | $3,715.35 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $4,168.69 | Professional | None | $1,122.02 | $1,548.82 | $4,168.69 |
Well Sense Setting Facility Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,949.84 | Facility | None | $912.01 | $1,288.25 | $1,949.84 |
Well Sense Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | None | $758.58 | $758.58 | $912.01 |
7 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 $549.54 Median $549.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $575.44 | Professional | 53 · Discontinued | $223.87 | $223.87 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $2,137.96 | Professional | 54 · Surgery only | $831.76 | $831.76 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $426.58 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $281.84 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,995.26 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $309.03 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $309.03 | $407.38 |
Where Massachusetts sits
The same service costs 3.7 times more in Wisconsin than in Montana. 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.
Physician feeFacility fee
WI $12,177MT $3,320
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.