How much rates vary
Facilitymedian $2,089 · 10th to 90th $407 to $4,074Professionalmedian $3,162 · 10th to 90th $1,995 to $13,804
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 $5,248.07 | Facility | None | $2,691.53 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,995.26 | $1,995.26 | $3,388.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,011.87 | Facility | None | $346.74 | $1,047.13 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,041.74 Median $5,495.41 Typical High $13,803.84 | Professional | None | $2,041.74 | $5,495.41 | $13,803.84 |
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 $2,754.23 Median $2,754.23 Typical High $5,370.32 | Professional | None | $2,754.23 | $2,754.23 | $5,370.32 |
Fallon Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $3,630.78 | Facility | None | $2,137.96 | $2,630.27 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,691.53 | $3,311.31 |
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 $2,344.23 Median $4,265.80 Typical High $6,456.54 | Professional | None | $2,344.23 | $4,265.80 | $6,456.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,011.87 | Facility | None | $346.74 | $1,047.13 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,041.74 Median $5,495.41 Typical High $13,803.84 | Professional | None | $2,041.74 | $5,495.41 | $13,803.84 |
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 $2,187.76 Median $3,090.30 Typical High $8,317.64 | Professional | None | $2,187.76 | $3,090.30 | $8,317.64 |
Well Sense Setting Facility Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,019.95 | Facility | None | $1,479.11 | $2,041.74 | $3,019.95 |
Well Sense Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,380.38 | $1,659.59 |
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 $1,000.00 Median $1,000.00 Typical High $2,630.27 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $1,071.52 | Professional | 53 · Discontinued | $398.11 | $398.11 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $3,981.07 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $794.33 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $524.81 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $3,715.35 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 82 · Assistant surgeon, no resident | $1,412.54 | $1,412.54 | $1,412.54 |
Where Massachusetts sits
The same service costs 13.8 times more in Maine than in Washington. 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 $35,114WA $2,549
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.