How much rates vary
Facilitymedian $2,884 · 10th to 90th $407 to $5,129Professionalmedian $5,129 · 10th to 90th $3,090 to $21,878
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 $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $7,943.28 | Professional | None | $3,090.30 | $3,090.30 | $7,943.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $7,762.47 | Facility | None | $346.74 | $1,047.13 | $7,762.47 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,019.95 Median $8,912.51 Typical High $21,877.62 | Professional | None | $3,019.95 | $8,912.51 | $21,877.62 |
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 $4,265.80 Median $4,265.80 Typical High $8,317.64 | Professional | None | $4,265.80 | $4,265.80 | $8,317.64 |
Fallon Health Setting Facility Modifier None Typical Low $3,311.31 Median $4,168.69 Typical High $5,128.61 | Facility | None | $3,311.31 | $4,168.69 | $5,128.61 |
Fallon Health Setting Professional Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $5,370.32 | Professional | None | $3,630.78 | $4,365.16 | $5,370.32 |
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 $3,630.78 Median $6,760.83 Typical High $10,232.93 | Professional | None | $3,630.78 | $6,760.83 | $10,232.93 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $7,762.47 | Facility | None | $346.74 | $1,047.13 | $7,762.47 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,019.95 Median $8,912.51 Typical High $21,877.62 | Professional | None | $3,019.95 | $8,912.51 | $21,877.62 |
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 $3,235.94 Median $4,786.30 Typical High $12,589.25 | Professional | None | $3,235.94 | $4,786.30 | $12,589.25 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $4,897.79 | Facility | None | $2,398.83 | $3,235.94 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,454.71 | Professional | None | $2,089.30 | $2,089.30 | $2,454.71 |
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 $1,548.82 Median $1,548.82 Typical High $3,981.07 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $1,584.89 | Professional | 53 · Discontinued | $616.60 | $616.60 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $5,888.44 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $1,174.90 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $794.33 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $5,495.41 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $3,467.37 Median $3,715.35 Typical High $5,011.87 | Professional | 62 · Two surgeons | $3,467.37 | $3,715.35 | $5,011.87 |
Where Massachusetts sits
The same service costs 12.3 times more in Maine than in Texas. 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 $36,433TX $2,961
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.