How much rates vary
Facilitymedian $1,995 · 10th to 90th $407 to $4,074Professionalmedian $3,020 · 10th to 90th $1,862 to $15,849
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 $1,862.09 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,862.09 | $1,862.09 | $3,162.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,677.35 | Facility | None | $346.74 | $1,047.13 | $4,677.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,949.84 Median $5,248.07 Typical High $15,848.93 | Professional | None | $1,949.84 | $5,248.07 | $15,848.93 |
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 $2,570.40 Median $2,570.40 Typical High $5,128.61 | Professional | None | $2,570.40 | $2,570.40 | $5,128.61 |
Fallon Health Setting Facility Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,467.37 | Facility | None | $1,995.26 | $2,454.71 | $3,467.37 |
Fallon Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,511.89 | $3,090.30 |
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 $2,187.76 Median $3,981.07 Typical High $6,025.60 | Professional | None | $2,187.76 | $3,981.07 | $6,025.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,677.35 | Facility | None | $346.74 | $1,047.13 | $4,677.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,949.84 Median $5,248.07 Typical High $15,848.93 | Professional | None | $1,949.84 | $5,248.07 | $15,848.93 |
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 $2,089.30 Median $2,951.21 Typical High $7,762.47 | Professional | None | $2,089.30 | $2,951.21 | $7,762.47 |
Well Sense Setting Facility Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,818.38 | Facility | None | $1,380.38 | $1,862.09 | $2,818.38 |
Well Sense Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,288.25 | $1,548.82 |
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 $933.25 Median $933.25 Typical High $2,511.89 | Professional | 52 · Reduced service | $933.25 | $933.25 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $1,000.00 | Professional | 53 · Discontinued | $380.19 | $380.19 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $758.58 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $501.19 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $3,548.13 |
Where Massachusetts sits
The same service costs 13.4 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 $34,930MD $2,604
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.