How much rates vary
Facilitymedian $1,349 · 10th to 90th $380 to $3,548Professionalmedian $1,995 · 10th to 90th $1,175 to $8,128
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 $1,174.90 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,174.90 | $2,754.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $933.25 Typical High $3,548.13 | Facility | None | $346.74 | $933.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,202.26 Median $3,162.28 Typical High $8,128.31 | Professional | None | $1,202.26 | $3,162.28 | $8,128.31 |
BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,862.09 | $2,818.38 |
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 $1,479.11 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,905.46 | $2,951.21 |
Fallon Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $3,311.31 | Facility | None | $1,122.02 | $1,548.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,621.81 | $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 $1,380.38 Median $2,570.40 Typical High $3,548.13 | Professional | None | $1,380.38 | $2,570.40 | $3,548.13 |
Health New England Setting Professional Modifier None Typical Low $275.42 Median $2,089.30 Typical High $2,089.30 | Professional | None | $275.42 | $2,089.30 | $2,089.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $933.25 Typical High $3,548.13 | Facility | None | $346.74 | $933.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,202.26 Median $3,162.28 Typical High $8,128.31 | Professional | None | $1,202.26 | $3,162.28 | $8,128.31 |
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 $1,202.26 Median $1,659.59 Typical High $4,677.35 | Professional | None | $1,202.26 | $1,659.59 | $4,677.35 |
Well Sense Setting Facility Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,819.70 | Facility | None | $891.25 | $1,230.27 | $1,819.70 |
Well Sense Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,148.15 | Professional | None | $851.14 | $851.14 | $1,148.15 |
12 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 $588.84 Median $588.84 Typical High $831.76 | Professional | 52 · Reduced service | $588.84 | $588.84 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $331.13 | Professional | 53 · Discontinued | $234.42 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,230.27 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $245.47 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $165.96 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,148.15 |
BCBS Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,047.13 Typical High $1,148.15 | Professional | 52 · Reduced service | $794.33 | $1,047.13 | $1,148.15 |
BCBS Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $537.03 Typical High $707.95 | Professional | 53 · Discontinued | $309.03 | $537.03 | $707.95 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,348.96 Typical High $1,778.28 | Professional | 62 · Two surgeons | $776.25 | $1,348.96 | $1,778.28 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,698.24 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,698.24 | $2,290.87 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $741.31 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | Q3 · Living kidney donor | $524.81 | $524.81 | $707.95 |
Where Massachusetts sits
The same service costs 10.1 times more in Maine than in Texas. 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 $17,434TX $1,719
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.