How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,000 to $7,244Professionalmedian $3,090 · 10th to 90th $1,778 to $12,303
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 $1,778.28 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,778.28 | $1,778.28 | $2,754.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $912.01 Median $3,090.30 Typical High $8,317.64 | Facility | None | $912.01 | $3,090.30 | $8,317.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,949.84 Median $4,786.30 Typical High $12,302.69 | Professional | None | $1,949.84 | $4,786.30 | $12,302.69 |
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 $2,398.83 Median $2,884.03 Typical High $4,466.84 | Professional | None | $2,398.83 | $2,884.03 | $4,466.84 |
Fallon Health Setting Facility Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,311.31 | Facility | None | $1,862.09 | $2,290.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,311.31 | Professional | None | $2,089.30 | $2,454.71 | $3,311.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,089.30 Median $3,890.45 Typical High $5,370.32 | Professional | None | $2,089.30 | $3,890.45 | $5,370.32 |
Health New England Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $912.01 Median $3,090.30 Typical High $8,317.64 | Facility | None | $912.01 | $3,090.30 | $8,317.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,949.84 Median $4,786.30 Typical High $12,302.69 | Professional | None | $1,949.84 | $4,786.30 | $12,302.69 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $9,332.54 | Facility | None | $1,071.52 | $3,890.45 | $9,332.54 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $7,585.78 | Professional | None | $1,905.46 | $2,570.40 | $7,585.78 |
Well Sense Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,754.23 | Facility | None | $1,348.96 | $1,862.09 | $2,754.23 |
Well Sense Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,288.25 | $1,737.80 |
4 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 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $371.54 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,737.80 |
Where Massachusetts sits
The same service costs 7.2 times more in Maine than in Delaware. 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 $28,702DE $3,966
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.