How much rates vary
Facilitymedian $1,148 · 10th to 90th $501 to $3,467Professionalmedian $1,905 · 10th to 90th $977 to $11,482
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 $1,380.38 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,380.38 | $2,818.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $977.24 Typical High $3,630.78 | Facility | None | $346.74 | $977.24 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,481.54 | Professional | None | $1,318.26 | $3,548.13 | $11,481.54 |
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 $1,778.28 Median $1,778.28 Typical High $4,466.84 | Professional | None | $1,778.28 | $1,778.28 | $4,466.84 |
Fallon Health Setting Facility Modifier None Typical Low $741.31 Median $1,445.44 Typical High $2,290.87 | Facility | None | $741.31 | $1,445.44 | $2,290.87 |
Fallon Health Setting Professional Modifier None Typical Low $741.31 Median $1,318.26 Typical High $1,905.46 | Professional | None | $741.31 | $1,318.26 | $1,905.46 |
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 $1,445.44 Median $2,511.89 Typical High $3,890.45 | Professional | None | $1,445.44 | $2,511.89 | $3,890.45 |
Health New England Setting Facility Modifier None Typical Low $25,118.86 Median $25,118.86 Typical High $25,118.86 | Facility | None | $25,118.86 | $25,118.86 | $25,118.86 |
Health New England Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $977.24 Typical High $3,630.78 | Facility | None | $346.74 | $977.24 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,481.54 | Professional | None | $1,318.26 | $3,548.13 | $11,481.54 |
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 $1,445.44 Median $1,949.84 Typical High $5,888.44 | Professional | None | $1,445.44 | $1,949.84 | $5,888.44 |
Well Sense Setting Facility Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,995.26 | Facility | None | $977.24 | $1,318.26 | $1,995.26 |
Well Sense Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
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 $691.83 Median $691.83 Typical High $2,089.30 | Professional | 52 · Reduced service | $691.83 | $691.83 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $831.76 | Professional | 53 · Discontinued | $275.42 | $275.42 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $630.96 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $416.87 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $2,951.21 |
Where Massachusetts sits
The same service costs 14.0 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 $28,122MD $2,008
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.