How much rates vary
Facilitymedian $1,778 · 10th to 90th $407 to $4,074Professionalmedian $2,512 · 10th to 90th $1,549 to $10,715
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 $1,548.82 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,548.82 | $2,570.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,148.15 Typical High $4,677.35 | Facility | None | $346.74 | $1,148.15 | $4,677.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $10,715.19 | Professional | None | $1,513.56 | $4,265.80 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,168.69 | Professional | None | $2,137.96 | $2,137.96 | $4,168.69 |
Fallon Health Setting Facility Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,311.31 | Facility | None | $1,621.81 | $2,041.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,778.28 | $2,089.30 | $2,570.40 |
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 $1,819.70 Median $3,311.31 Typical High $5,011.87 | Professional | None | $1,819.70 | $3,311.31 | $5,011.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,148.15 Typical High $4,677.35 | Facility | None | $346.74 | $1,148.15 | $4,677.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $10,715.19 | Professional | None | $1,513.56 | $4,265.80 | $10,715.19 |
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 $1,698.24 Median $2,398.83 Typical High $6,309.57 | Professional | None | $1,698.24 | $2,398.83 | $6,309.57 |
Well Sense Setting Facility Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,290.87 | Facility | None | $1,122.02 | $1,513.56 | $2,290.87 |
Well Sense Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
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 $776.25 Median $776.25 Typical High $2,041.74 | Professional | 52 · Reduced service | $776.25 | $776.25 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $812.83 | Professional | 53 · Discontinued | $309.03 | $309.03 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $616.60 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $407.38 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $2,884.03 |
Where Massachusetts sits
The same service costs 15.5 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 $34,449MD $2,222
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.