How much rates vary
Facilitymedian $1,202 · 10th to 90th $525 to $3,548Professionalmedian $2,089 · 10th to 90th $1,072 to $17,783
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 $1,513.56 Median $1,513.56 Typical High $4,570.88 | Professional | None | $1,513.56 | $1,513.56 | $4,570.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,630.78 | Facility | None | $346.74 | $1,047.13 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,412.54 Median $3,890.45 Typical High $17,782.79 | Professional | None | $1,412.54 | $3,890.45 | $17,782.79 |
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 $1,949.84 Median $1,949.84 Typical High $4,897.79 | Professional | None | $1,949.84 | $1,949.84 | $4,897.79 |
Fallon Health Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $2,754.23 | Facility | None | $794.33 | $1,584.89 | $2,754.23 |
Fallon Health Setting Professional Modifier None Typical Low $812.83 Median $1,445.44 Typical High $2,089.30 | Professional | None | $812.83 | $1,445.44 | $2,089.30 |
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 $1,584.89 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,584.89 | $2,754.23 | $4,265.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,630.78 | Facility | None | $346.74 | $1,047.13 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,412.54 Median $3,890.45 Typical High $17,782.79 | Professional | None | $1,412.54 | $3,890.45 | $17,782.79 |
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 $1,584.89 Median $2,137.96 Typical High $6,606.93 | Professional | None | $1,584.89 | $2,137.96 | $6,606.93 |
Well Sense Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,187.76 | Facility | None | $1,071.52 | $1,479.11 | $2,187.76 |
Well Sense Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,148.15 | $1,380.38 |
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 $758.58 Median $758.58 Typical High $2,290.87 | Professional | 52 · Reduced service | $758.58 | $758.58 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $912.01 | Professional | 53 · Discontinued | $302.00 | $302.00 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $676.08 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $457.09 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $3,162.28 |
Where Massachusetts sits
The same service costs 11.6 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 $24,998MD $2,147
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.