How much rates vary
Facilitymedian $1,023 · 10th to 90th $501 to $3,388Professionalmedian $1,479 · 10th to 90th $759 to $7,413
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 $1,071.52 Median $1,071.52 Typical High $3,235.94 | Professional | None | $1,071.52 | $1,071.52 | $3,235.94 |
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 $1,000.00 Median $2,754.23 Typical High $7,413.10 | Professional | None | $1,000.00 | $2,754.23 | $7,413.10 |
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 $1,380.38 Median $1,380.38 Typical High $3,467.37 | Professional | None | $1,380.38 | $1,380.38 | $3,467.37 |
Fallon Health Setting Facility Modifier None Typical Low $575.44 Median $1,122.02 Typical High $1,995.26 | Facility | None | $575.44 | $1,122.02 | $1,995.26 |
Fallon Health Setting Professional Modifier None Typical Low $575.44 Median $1,023.29 Typical High $1,479.11 | Professional | None | $575.44 | $1,023.29 | $1,479.11 |
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 $1,122.02 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,122.02 | $1,995.26 | $3,019.95 |
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 $1,000.00 Median $2,754.23 Typical High $7,413.10 | Professional | None | $1,000.00 | $2,754.23 | $7,413.10 |
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 $1,096.48 Median $1,513.56 Typical High $4,570.88 | Professional | None | $1,096.48 | $1,513.56 | $4,570.88 |
Well Sense Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,548.82 | Facility | None | $758.58 | $1,023.29 | $1,548.82 |
Well Sense Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
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 $524.81 Median $524.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $645.65 | Professional | 53 · Discontinued | $213.80 | $213.80 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $2,454.71 | Professional | 54 · Surgery only | $794.33 | $794.33 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $489.78 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $323.59 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $2,290.87 |
Where Massachusetts sits
The same service costs 14.5 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 $24,354MD $1,684
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.