How much rates vary
Facilitymedian $1,514 · 10th to 90th $407 to $3,715Professionalmedian $2,042 · 10th to 90th $1,202 to $8,913
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 $3,467.37 Typical High $7,413.10 | Facility | None | $2,691.53 | $3,467.37 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,513.56 | Professional | None | $977.24 | $977.24 | $1,513.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $977.24 Typical High $3,715.35 | Facility | None | $316.23 | $977.24 | $3,715.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,288.25 Median $3,162.28 Typical High $8,912.51 | Professional | None | $1,288.25 | $3,162.28 | $8,912.51 |
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 $2,041.74 Median $2,041.74 Typical High $3,630.78 | Professional | None | $2,041.74 | $2,041.74 | $3,630.78 |
Fallon Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,311.31 | Facility | None | $1,348.96 | $1,659.59 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,659.59 | $1,995.26 |
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 $1,479.11 Median $2,691.53 Typical High $4,168.69 | Professional | None | $1,479.11 | $2,691.53 | $4,168.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $977.24 Typical High $3,715.35 | Facility | None | $316.23 | $977.24 | $3,715.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,288.25 Median $3,162.28 Typical High $8,912.51 | Professional | None | $1,288.25 | $3,162.28 | $8,912.51 |
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 $1,621.81 Median $2,187.76 Typical High $5,888.44 | Professional | None | $1,621.81 | $2,187.76 | $5,888.44 |
Well Sense Setting Facility Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,995.26 | Facility | None | $977.24 | $1,318.26 | $1,995.26 |
Well Sense Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,071.52 | $1,288.25 |
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 $489.78 Median $489.78 Typical High $758.58 | Professional | 52 · Reduced service | $489.78 | $489.78 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $302.00 | Professional | 53 · Discontinued | $194.98 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $1,148.15 | Professional | 54 · Surgery only | $724.44 | $724.44 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $229.09 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $151.36 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $151.36 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $363.08 Typical High $489.78 | Professional | 80 · Assistant surgeon | $281.84 | $363.08 | $489.78 |
Where Massachusetts sits
The same service costs 25.6 times more in Maine than in Maryland. 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
ME $53,236MD $2,076
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.