How much rates vary
Facilitymedian $1,318 · 10th to 90th $407 to $3,548Professionalmedian $1,862 · 10th to 90th $1,175 to $11,482
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 $1,174.90 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,174.90 | $2,754.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $912.01 Typical High $3,548.13 | Facility | None | $346.74 | $912.01 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,202.26 Median $3,235.94 Typical High $11,481.54 | Professional | None | $1,202.26 | $3,235.94 | $11,481.54 |
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 $1,584.89 Median $1,584.89 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,584.89 | $3,162.28 |
Fallon Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $3,311.31 | Facility | None | $1,230.27 | $1,548.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,548.82 | $1,905.46 |
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 $1,348.96 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,348.96 | $2,454.71 | $3,715.35 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $912.01 Typical High $3,548.13 | Facility | None | $346.74 | $912.01 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,202.26 Median $3,235.94 Typical High $11,481.54 | Professional | None | $1,202.26 | $3,235.94 | $11,481.54 |
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 $1,288.25 Median $1,778.28 Typical High $4,786.30 | Professional | None | $1,288.25 | $1,778.28 | $4,786.30 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,737.80 | Facility | None | $851.14 | $1,148.15 | $1,737.80 |
Well Sense Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | None | $794.33 | $794.33 | $954.99 |
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 $575.44 Median $575.44 Typical High $1,548.82 | Professional | 52 · Reduced service | $575.44 | $575.44 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $616.60 | Professional | 53 · Discontinued | $234.42 | $234.42 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $2,344.23 | Professional | 54 · Surgery only | $870.96 | $870.96 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $467.74 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $309.03 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $2,187.76 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,318.26 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,230.27 | $1,318.26 | $1,778.28 |
Where Massachusetts sits
The same service costs 8.8 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 $16,376MD $1,851
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.