How much rates vary
Facilitymedian $1,698 · 10th to 90th $407 to $3,715Professionalmedian $2,239 · 10th to 90th $1,349 to $10,000
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 $1,071.52 Median $1,071.52 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,071.52 | $1,949.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $1,047.13 Typical High $4,073.80 | Facility | None | $316.23 | $1,047.13 | $4,073.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $10,000.00 | Professional | None | $1,412.54 | $3,467.37 | $10,000.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,479.11 | $2,344.23 | $3,162.28 |
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 $2,238.72 Median $2,238.72 Typical High $3,981.07 | Professional | None | $2,238.72 | $2,238.72 | $3,981.07 |
Fallon Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,479.11 | $1,862.09 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,819.70 | $2,238.72 |
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 $1,659.59 Median $3,019.95 Typical High $4,570.88 | Professional | None | $1,659.59 | $3,019.95 | $4,570.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $1,047.13 Typical High $4,073.80 | Facility | None | $316.23 | $1,047.13 | $4,073.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $10,000.00 | Professional | None | $1,412.54 | $3,467.37 | $10,000.00 |
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 $1,819.70 Median $2,454.71 Typical High $6,606.93 | Professional | None | $1,819.70 | $2,454.71 | $6,606.93 |
Well Sense Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,238.72 | Facility | None | $1,071.52 | $1,479.11 | $2,238.72 |
Well Sense Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,202.26 | $1,445.44 |
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 $537.03 Median $537.03 Typical High $831.76 | Professional | 52 · Reduced service | $537.03 | $537.03 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $338.84 | Professional | 53 · Discontinued | $213.80 | $213.80 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $1,258.93 | Professional | 54 · Surgery only | $794.33 | $794.33 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $251.19 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $165.96 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $165.96 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,584.89 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,230.27 | $1,584.89 | $2,089.30 |
Where Massachusetts sits
The same service costs 24.1 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 $53,525MD $2,222
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.