How much rates vary
Facilitymedian $1,000 · 10th to 90th $479 to $4,898Professionalmedian $1,122 · 10th to 90th $562 to $9,772
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 $2,398.83 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,398.83 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,398.83 | Professional | None | $812.83 | $812.83 | $2,398.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $5,623.41 | Facility | None | $575.44 | $1,905.46 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $758.58 Median $2,041.74 Typical High $9,772.37 | Professional | None | $758.58 | $2,041.74 | $9,772.37 |
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 $1,047.13 Median $1,047.13 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,047.13 | $2,570.40 |
Fallon Health Setting Facility Modifier None Typical Low $436.52 Median $851.14 Typical High $1,479.11 | Facility | None | $436.52 | $851.14 | $1,479.11 |
Fallon Health Setting Professional Modifier None Typical Low $436.52 Median $776.25 Typical High $1,122.02 | Professional | None | $436.52 | $776.25 | $1,122.02 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $851.14 Median $1,479.11 Typical High $2,290.87 | Professional | None | $851.14 | $1,479.11 | $2,290.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $5,623.41 | Facility | None | $575.44 | $1,905.46 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $758.58 Median $2,041.74 Typical High $9,772.37 | Professional | None | $758.58 | $2,041.74 | $9,772.37 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $7,244.36 | Facility | None | $851.14 | $2,818.38 | $7,244.36 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $3,467.37 | Professional | None | $831.76 | $1,122.02 | $3,467.37 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $1,174.90 | Facility | None | $562.34 | $758.58 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | None | $602.56 | $602.56 | $724.44 |
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 $407.38 Median $407.38 Typical High $1,202.26 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $478.63 | Professional | 53 · Discontinued | $162.18 | $162.18 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $1,778.28 | Professional | 54 · Surgery only | $602.56 | $602.56 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $363.08 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $239.88 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $1,659.59 |
Where Massachusetts sits
The same service costs 7.8 times more in Maine than in Massachusetts. 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 $16,585MA $2,122
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.