How much rates vary
Facilitymedian $1,288 · 10th to 90th $407 to $3,715Professionalmedian $1,738 · 10th to 90th $1,023 to $7,586
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 $3,630.78 Typical High $8,709.64 | Facility | None | $2,691.53 | $3,630.78 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,258.93 | Professional | None | $812.83 | $812.83 | $1,258.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $831.76 Typical High $3,630.78 | Facility | None | $316.23 | $831.76 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $7,585.78 | Professional | None | $1,096.48 | $2,691.53 | $7,585.78 |
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 $1,737.80 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,737.80 | $1,737.80 | $3,090.30 |
Fallon Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $3,311.31 | Facility | None | $1,148.15 | $1,412.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,412.54 | $1,698.24 |
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 $1,258.93 Median $2,290.87 Typical High $3,548.13 | Professional | None | $1,258.93 | $2,290.87 | $3,548.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $831.76 Typical High $3,630.78 | Facility | None | $316.23 | $831.76 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $7,585.78 | Professional | None | $1,096.48 | $2,691.53 | $7,585.78 |
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 $1,380.38 Median $1,862.09 Typical High $5,011.87 | Professional | None | $1,380.38 | $1,862.09 | $5,011.87 |
Well Sense Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,698.24 | Facility | None | $831.76 | $1,148.15 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | None | $891.25 | $891.25 | $1,071.52 |
5 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 $398.11 Median $398.11 Typical High $630.96 | Professional | 52 · Reduced service | $398.11 | $398.11 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $251.19 | Professional | 53 · Discontinued | $162.18 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $954.99 | Professional | 54 · Surgery only | $602.56 | $602.56 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $190.55 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $125.89 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $125.89 |
Where Massachusetts sits
The same service costs 15.0 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 $27,402MD $1,821
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.