How much rates vary
Facilitymedian $2,630 · 10th to 90th $407 to $4,365Professionalmedian $4,074 · 10th to 90th $2,630 to $18,197
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 $2,630.27 Median $2,630.27 Typical High $5,370.32 | Professional | None | $2,630.27 | $2,630.27 | $5,370.32 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,456.54 | Facility | None | $346.74 | $1,047.13 | $6,456.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,691.53 Median $7,244.36 Typical High $18,197.01 | Professional | None | $2,691.53 | $7,244.36 | $18,197.01 |
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 $3,630.78 Median $3,630.78 Typical High $7,079.46 | Professional | None | $3,630.78 | $3,630.78 | $7,079.46 |
Fallon Health Setting Facility Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $4,073.80 | Facility | None | $2,691.53 | $3,311.31 | $4,073.80 |
Fallon Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $4,168.69 | Professional | None | $2,884.03 | $3,388.44 | $4,168.69 |
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 $3,019.95 Median $5,495.41 Typical High $8,317.64 | Professional | None | $3,019.95 | $5,495.41 | $8,317.64 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,456.54 | Facility | None | $346.74 | $1,047.13 | $6,456.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,691.53 Median $7,244.36 Typical High $18,197.01 | Professional | None | $2,691.53 | $7,244.36 | $18,197.01 |
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 $2,884.03 Median $4,073.80 Typical High $10,715.19 | Professional | None | $2,884.03 | $4,073.80 | $10,715.19 |
Well Sense Setting Facility Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $3,890.45 | Facility | None | $1,905.46 | $2,570.40 | $3,890.45 |
Well Sense Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,819.70 | $1,819.70 | $2,137.96 |
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 $1,318.26 Median $1,318.26 Typical High $3,548.13 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $1,412.54 | Professional | 53 · Discontinued | $524.81 | $524.81 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $5,248.07 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $1,047.13 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $707.95 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $4,897.79 |
Where Massachusetts sits
The same service costs 12.3 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 $35,907WA $2,929
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.