How much rates vary
Facilitymedian $1,622 · 10th to 90th $407 to $3,631Professionalmedian $2,399 · 10th to 90th $1,349 to $12,023
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 $1,023.29 Median $1,023.29 Typical High $4,677.35 | Professional | None | $1,023.29 | $1,023.29 | $4,677.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,630.78 | Facility | None | $346.74 | $1,047.13 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,412.54 Median $3,548.13 Typical High $12,022.64 | Professional | None | $1,412.54 | $3,548.13 | $12,022.64 |
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 $2,290.87 Median $2,290.87 Typical High $4,073.80 | Professional | None | $2,290.87 | $2,290.87 | $4,073.80 |
Fallon Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $3,311.31 | Facility | None | $1,479.11 | $1,819.70 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,819.70 | $2,187.76 |
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 $346.74 Median $1,047.13 Typical High $3,630.78 | Facility | None | $346.74 | $1,047.13 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,412.54 Median $3,548.13 Typical High $12,022.64 | Professional | None | $1,412.54 | $3,548.13 | $12,022.64 |
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 $1,778.28 Median $2,511.89 Typical High $6,606.93 | Professional | None | $1,778.28 | $2,511.89 | $6,606.93 |
Well Sense Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,238.72 | Facility | None | $1,096.48 | $1,513.56 | $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 |
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 $512.86 Median $512.86 Typical High $2,344.23 | Professional | 52 · Reduced service | $512.86 | $512.86 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $933.25 | Professional | 53 · Discontinued | $204.17 | $204.17 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $3,467.37 | Professional | 54 · Surgery only | $758.58 | $758.58 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $691.83 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $467.74 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $3,235.94 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon + 82 · Assistant surgeon, no resident Typical Low $309.03 Median $398.11 Typical High $524.81 | Professional | 80 · Assistant surgeon + 82 · Assistant surgeon, no resident | $309.03 | $398.11 | $524.81 |
Where Massachusetts sits
The same service costs 7.5 times more in Maine than in Washington. 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 $16,364WA $2,175
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.