How much rates vary
Facilitymedian $2,344 · 10th to 90th $407 to $4,169Professionalmedian $3,981 · 10th to 90th $2,512 to $16,596
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 $2,570.40 Median $2,570.40 Typical High $7,079.46 | Professional | None | $2,570.40 | $2,570.40 | $7,079.46 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,495.41 | Facility | None | $346.74 | $1,047.13 | $5,495.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,511.89 Median $6,606.93 Typical High $16,595.87 | Professional | None | $2,511.89 | $6,606.93 | $16,595.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $3,388.44 Median $3,388.44 Typical High $6,606.93 | Professional | None | $3,388.44 | $3,388.44 | $6,606.93 |
Fallon Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $3,630.78 | Facility | None | $2,344.23 | $2,884.03 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,454.71 | $2,884.03 | $3,548.13 |
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 $2,511.89 Median $4,570.88 Typical High $7,079.46 | Professional | None | $2,511.89 | $4,570.88 | $7,079.46 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,495.41 | Facility | None | $346.74 | $1,047.13 | $5,495.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,511.89 Median $6,606.93 Typical High $16,595.87 | Professional | None | $2,511.89 | $6,606.93 | $16,595.87 |
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 $2,754.23 Median $3,801.89 Typical High $10,232.93 | Professional | None | $2,754.23 | $3,801.89 | $10,232.93 |
Well Sense Setting Facility Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $3,801.89 | Facility | None | $1,819.70 | $2,511.89 | $3,801.89 |
Well Sense Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
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 $1,258.93 Median $1,258.93 Typical High $3,548.13 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $1,412.54 | Professional | 53 · Discontinued | $512.86 | $512.86 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $5,370.32 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $1,071.52 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $707.95 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $5,011.87 |
Where Massachusetts sits
The same service costs 13.0 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 $35,671WA $2,745
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.