How much rates vary
Facilitymedian $1,148 · 10th to 90th $525 to $3,467Professionalmedian $1,820 · 10th to 90th $912 to $21,878
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 $1,288.25 Median $1,288.25 Typical High $3,890.45 | Professional | None | $1,288.25 | $1,288.25 | $3,890.45 |
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 $1,230.27 Median $3,311.31 Typical High $21,877.62 | Professional | None | $1,230.27 | $3,311.31 | $21,877.62 |
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 $1,698.24 Median $1,698.24 Typical High $4,168.69 | Professional | None | $1,698.24 | $1,698.24 | $4,168.69 |
Fallon Health Setting Facility Modifier None Typical Low $707.95 Median $1,380.38 Typical High $2,187.76 | Facility | None | $707.95 | $1,380.38 | $2,187.76 |
Fallon Health Setting Professional Modifier None Typical Low $707.95 Median $1,258.93 Typical High $1,819.70 | Professional | None | $707.95 | $1,258.93 | $1,819.70 |
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 $1,348.96 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,348.96 | $2,398.83 | $3,715.35 |
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 $1,230.27 Median $3,311.31 Typical High $21,877.62 | Professional | None | $1,230.27 | $3,311.31 | $21,877.62 |
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 $1,348.96 Median $1,819.70 Typical High $5,623.41 | Professional | None | $1,348.96 | $1,819.70 | $5,623.41 |
Well Sense Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,905.46 | Facility | None | $912.01 | $1,258.93 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | None | $977.24 | $977.24 | $1,174.90 |
7 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 $645.65 Median $645.65 Typical High $1,949.84 | Professional | 52 · Reduced service | $645.65 | $645.65 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $776.25 | Professional | 53 · Discontinued | $257.04 | $257.04 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $2,951.21 | Professional | 54 · Surgery only | $954.99 | $954.99 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $588.84 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $389.05 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $2,754.23 |
BCBS Massachusetts 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 |
Where Massachusetts sits
The same service costs 9.0 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 $17,266MD $1,911
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.