How much rates vary
Facilitymedian $1,413 · 10th to 90th $407 to $3,548Professionalmedian $2,138 · 10th to 90th $1,175 to $10,471
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 $3,090.30 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $4,168.69 | Professional | None | $912.01 | $912.01 | $4,168.69 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $954.99 Typical High $3,630.78 | Facility | None | $346.74 | $954.99 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,471.29 | Professional | None | $1,258.93 | $3,090.30 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,949.84 | $1,949.84 | $3,548.13 |
Fallon Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $3,311.31 | Facility | None | $1,318.26 | $1,621.81 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,621.81 | $1,949.84 |
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 $4,073.80 | Professional | None | $1,479.11 | $2,691.53 | $4,073.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $954.99 Typical High $3,630.78 | Facility | None | $346.74 | $954.99 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,471.29 | Professional | None | $1,258.93 | $3,090.30 | $10,471.29 |
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 $2,238.72 Typical High $5,888.44 | Professional | None | $1,621.81 | $2,238.72 | $5,888.44 |
Well Sense Setting Facility Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,995.26 | Facility | None | $954.99 | $1,288.25 | $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 $457.09 Median $457.09 Typical High $2,089.30 | Professional | 52 · Reduced service | $457.09 | $457.09 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $831.76 | Professional | 53 · Discontinued | $181.97 | $181.97 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $3,090.30 | Professional | 54 · Surgery only | $676.08 | $676.08 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $616.60 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $416.87 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $2,884.03 |
Where Massachusetts sits
The same service costs 7.5 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 $16,075MD $2,147
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.