How much rates vary
Facilitymedian $2,344 · 10th to 90th $407 to $4,169Professionalmedian $3,548 · 10th to 90th $2,291 to $15,488
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 $2,290.87 Median $2,290.87 Typical High $6,165.95 | Professional | None | $2,290.87 | $2,290.87 | $6,165.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,623.41 | Facility | None | $346.74 | $1,047.13 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,290.87 Median $5,370.32 Typical High $15,488.17 | Professional | None | $2,290.87 | $5,370.32 | $15,488.17 |
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 $3,162.28 Median $3,162.28 Typical High $5,888.44 | Professional | None | $3,162.28 | $3,162.28 | $5,888.44 |
Fallon Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $3,630.78 | Facility | None | $2,398.83 | $2,951.21 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,548.13 | Professional | None | $2,630.27 | $3,090.30 | $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 $2,630.27 Median $4,786.30 Typical High $6,918.31 | Professional | None | $2,630.27 | $4,786.30 | $6,918.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,623.41 | Facility | None | $346.74 | $1,047.13 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,290.87 Median $5,370.32 Typical High $15,488.17 | Professional | None | $2,290.87 | $5,370.32 | $15,488.17 |
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 $2,398.83 Median $3,467.37 Typical High $10,232.93 | Professional | None | $2,398.83 | $3,467.37 | $10,232.93 |
Well Sense Setting Facility Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,467.37 | Facility | None | $1,698.24 | $2,344.23 | $3,467.37 |
Well Sense Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,584.89 | $2,137.96 |
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 $1,148.15 Median $1,148.15 Typical High $3,090.30 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $1,230.27 | Professional | 53 · Discontinued | $467.74 | $467.74 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $933.25 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $616.60 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $4,365.16 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $660.69 Typical High $870.96 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $660.69 | $870.96 |
Where Massachusetts sits
The same service costs 13.8 times more in Maine than in Texas. 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 $35,114TX $2,545
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.