How much rates vary
Facilitymedian $1,000 · 10th to 90th $501 to $3,388Professionalmedian $1,445 · 10th to 90th $759 to $6,761
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 $2,951.21 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,951.21 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,951.21 | Professional | None | $1,071.52 | $1,071.52 | $2,951.21 |
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 $1,023.29 Median $2,691.53 Typical High $6,760.83 | Professional | None | $1,023.29 | $2,691.53 | $6,760.83 |
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 $3,388.44 | Professional | None | $1,380.38 | $1,380.38 | $3,388.44 |
Fallon Health Setting Facility Modifier None Typical Low $562.34 Median $1,096.48 Typical High $1,905.46 | Facility | None | $562.34 | $1,096.48 | $1,905.46 |
Fallon Health Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,445.44 | Professional | None | $562.34 | $1,000.00 | $1,445.44 |
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 $1,096.48 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,905.46 | $2,951.21 |
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 $1,023.29 Median $2,691.53 Typical High $6,760.83 | Professional | None | $1,023.29 | $2,691.53 | $6,760.83 |
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 $758.58 Median $758.58 Typical High $912.01 | Professional | None | $758.58 | $758.58 | $912.01 |
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 $1,479.11 | Professional | 52 · Reduced service | $524.81 | $524.81 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $588.84 | Professional | 53 · Discontinued | $213.80 | $213.80 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $2,187.76 | Professional | 54 · Surgery only | $794.33 | $794.33 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $446.68 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $295.12 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $2,041.74 |
Where Massachusetts sits
The same service costs 10.1 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 $16,934MD $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.