How much rates vary
Facilitymedian $1,148 · 10th to 90th $525 to $3,467Professionalmedian $1,862 · 10th to 90th $955 to $9,120
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 $4,073.80 | Professional | None | $1,318.26 | $1,318.26 | $4,073.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $954.99 Typical High $3,630.78 | Facility | None | $346.74 | $954.99 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,230.27 Median $3,467.37 Typical High $9,120.11 | Professional | None | $1,230.27 | $3,467.37 | $9,120.11 |
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 $1,737.80 Median $1,737.80 Typical High $4,365.16 | Professional | None | $1,737.80 | $1,737.80 | $4,365.16 |
Fallon Health Setting Facility Modifier None Typical Low $724.44 Median $1,412.54 Typical High $2,238.72 | Facility | None | $724.44 | $1,412.54 | $2,238.72 |
Fallon Health Setting Professional Modifier None Typical Low $724.44 Median $1,288.25 Typical High $1,862.09 | Professional | None | $724.44 | $1,288.25 | $1,862.09 |
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 $1,412.54 Median $2,570.40 Typical High $3,890.45 | Professional | None | $1,412.54 | $2,570.40 | $3,890.45 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $954.99 Typical High $3,630.78 | Facility | None | $346.74 | $954.99 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,230.27 Median $3,467.37 Typical High $9,120.11 | Professional | None | $1,230.27 | $3,467.37 | $9,120.11 |
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 $1,412.54 Median $1,995.26 Typical High $5,248.07 | Professional | None | $1,412.54 | $1,995.26 | $5,248.07 |
Well Sense Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,949.84 | Facility | None | $954.99 | $1,318.26 | $1,949.84 |
Well Sense Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,023.29 | $1,230.27 |
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 $2,041.74 | Professional | 52 · Reduced service | $660.69 | $660.69 | $2,041.74 |
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 $1,000.00 Median $1,000.00 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $616.60 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $407.38 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $2,884.03 |
Where Massachusetts sits
The same service costs 12.1 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 $24,728MD $2,041
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.