How much rates vary
Facilitymedian $977 · 10th to 90th $347 to $3,631Professionalmedian $1,175 · 10th to 90th $692 to $5,248
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 $3,235.94 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,235.94 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $851.14 | Professional | None | $562.34 | $562.34 | $851.14 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $794.33 Typical High $3,630.78 | Facility | None | $316.23 | $794.33 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $758.58 Median $1,862.09 Typical High $5,248.07 | Professional | None | $758.58 | $1,862.09 | $5,248.07 |
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 $1,174.90 Median $1,174.90 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,174.90 | $2,089.30 |
Fallon Health Setting Facility Modifier None Typical Low $794.33 Median $977.24 Typical High $3,311.31 | Facility | None | $794.33 | $977.24 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,174.90 | Professional | None | $831.76 | $977.24 | $1,174.90 |
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 $870.96 Median $1,584.89 Typical High $2,398.83 | Professional | None | $870.96 | $1,584.89 | $2,398.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $794.33 Typical High $3,630.78 | Facility | None | $316.23 | $794.33 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $758.58 Median $1,862.09 Typical High $5,248.07 | Professional | None | $758.58 | $1,862.09 | $5,248.07 |
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 $954.99 Median $1,288.25 Typical High $3,467.37 | Professional | None | $954.99 | $1,288.25 | $3,467.37 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $776.25 Typical High $1,148.15 | Facility | None | $562.34 | $776.25 | $1,148.15 |
Well Sense Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | None | $630.96 | $630.96 | $758.58 |
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 $281.84 Median $281.84 Typical High $436.52 | Professional | 52 · Reduced service | $281.84 | $281.84 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | 53 · Discontinued | $112.20 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $660.69 | Professional | 54 · Surgery only | $426.58 | $426.58 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $87.10 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $616.60 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $213.80 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $213.80 | $281.84 |
Where Massachusetts sits
The same service costs 18.7 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 $26,826MD $1,433
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.