How much rates vary
Facilitymedian $1,023 · 10th to 90th $363 to $3,311Professionalmedian $1,820 · 10th to 90th $933 to $10,965
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 $1,318.26 Median $1,318.26 Typical High $3,981.07 | Professional | None | $1,318.26 | $1,318.26 | $3,981.07 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $851.14 Typical High $3,548.13 | Facility | None | $323.59 | $851.14 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,258.93 Median $3,388.44 Typical High $10,964.78 | Professional | None | $1,258.93 | $3,388.44 | $10,964.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $446.68 Typical High $954.99 | Facility | None | $50.12 | $446.68 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $4,265.80 | Professional | None | $1,698.24 | $1,698.24 | $4,265.80 |
Fallon Health Setting Facility Modifier None Typical Low $724.44 Median $1,412.54 Typical High $3,311.31 | Facility | None | $724.44 | $1,412.54 | $3,311.31 |
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 $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,380.38 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,380.38 | $2,454.71 | $3,801.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $851.14 Typical High $3,548.13 | Facility | None | $323.59 | $851.14 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,258.93 Median $3,388.44 Typical High $10,964.78 | Professional | None | $1,258.93 | $3,388.44 | $10,964.78 |
United Setting Facility Modifier None Typical Low $323.59 Median $741.31 Typical High $4,168.69 | Facility | None | $323.59 | $741.31 | $4,168.69 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $5,754.40 | Professional | None | $1,348.96 | $1,862.09 | $5,754.40 |
Well Sense Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,905.46 | Facility | None | $933.25 | $1,288.25 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,000.00 | $1,202.26 |
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 $660.69 Median $660.69 Typical High $1,995.26 | Professional | 52 · Reduced service | $660.69 | $660.69 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $812.83 | Professional | 53 · Discontinued | $263.03 | $263.03 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $3,019.95 | Professional | 54 · Surgery only | $977.24 | $977.24 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $602.56 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $398.11 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $2,818.38 |
Where Massachusetts sits
The same service costs 13.1 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 $24,687MD $1,882
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.