How much rates vary
Facilitymedian $1,047 · 10th to 90th $407 to $3,548Professionalmedian $1,318 · 10th to 90th $832 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 $2,344.23 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,344.23 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $776.25 Typical High $3,548.13 | Facility | None | $346.74 | $776.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $891.25 Median $2,290.87 Typical High $10,000.00 | Professional | None | $891.25 | $2,290.87 | $10,000.00 |
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 $1,230.27 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,318.26 | $2,344.23 |
Fallon Health Setting Facility Modifier None Typical Low $891.25 Median $1,122.02 Typical High $3,311.31 | Facility | None | $891.25 | $1,122.02 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,380.38 | Professional | None | $954.99 | $1,122.02 | $1,380.38 |
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 $977.24 Median $1,778.28 Typical High $2,630.27 | Professional | None | $977.24 | $1,778.28 | $2,630.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $776.25 Typical High $3,548.13 | Facility | None | $346.74 | $776.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $891.25 Median $2,290.87 Typical High $10,000.00 | Professional | None | $891.25 | $2,290.87 | $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 $954.99 Median $1,230.27 Typical High $2,951.21 | Professional | None | $954.99 | $1,230.27 | $2,951.21 |
Well Sense Setting Facility Modifier None Typical Low $616.60 Median $831.76 Typical High $1,288.25 | Facility | None | $616.60 | $831.76 | $1,288.25 |
Well Sense Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | None | $602.56 | $602.56 | $724.44 |
8 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 $416.87 Median $416.87 Typical High $1,174.90 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $467.74 | Professional | 53 · Discontinued | $165.96 | $165.96 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $1,737.80 | Professional | 54 · Surgery only | $616.60 | $616.60 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $346.74 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $234.42 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,621.81 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,230.27 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $724.44 | $1,230.27 | $1,621.81 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $245.47 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $245.47 | $331.13 |
Where Massachusetts sits
The same service costs 18.1 times more in Maine than in Arkansas. 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 $27,451AR $1,513
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.