How much rates vary
Facilitymedian $1,175 · 10th to 90th $407 to $3,548Professionalmedian $1,622 · 10th to 90th $1,047 to $12,589
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 $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,047.13 | $2,754.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $794.33 Typical High $3,548.13 | Facility | None | $346.74 | $794.33 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $12,589.25 | Professional | None | $1,023.29 | $2,754.23 | $12,589.25 |
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 $1,348.96 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,348.96 | $2,630.27 |
Fallon Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $3,311.31 | Facility | None | $1,047.13 | $1,348.96 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,348.96 | $1,659.59 |
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 $1,174.90 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,174.90 | $2,137.96 | $3,235.94 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $794.33 Typical High $3,548.13 | Facility | None | $346.74 | $794.33 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $12,589.25 | Professional | None | $1,023.29 | $2,754.23 | $12,589.25 |
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 $1,096.48 Median $1,513.56 Typical High $4,073.80 | Professional | None | $1,096.48 | $1,513.56 | $4,073.80 |
Well Sense Setting Facility Modifier None Typical Low $724.44 Median $977.24 Typical High $1,479.11 | Facility | None | $724.44 | $977.24 | $1,479.11 |
Well Sense Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
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 $524.81 Median $524.81 Typical High $1,380.38 | Professional | 52 · Reduced service | $524.81 | $524.81 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $549.54 | Professional | 53 · Discontinued | $208.93 | $208.93 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $2,041.74 | Professional | 54 · Surgery only | $776.25 | $776.25 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $407.38 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $275.42 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $1,905.46 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,148.15 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,000.00 | $1,148.15 | $1,513.56 |
Where Massachusetts sits
The same service costs 9.8 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 $16,204MD $1,659
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.