How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,096 to $7,413Professionalmedian $4,365 · 10th to 90th $2,818 to $19,498
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 $2,818.38 Median $2,818.38 Typical High $7,413.10 | Professional | None | $2,818.38 | $2,818.38 | $7,413.10 |
AllWays Health Partners Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $10,232.93 | Facility | None | $758.58 | $2,884.03 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,818.38 Median $6,606.93 Typical High $19,498.45 | Professional | None | $2,818.38 | $6,606.93 | $19,498.45 |
BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $17,378.01 Typical High $17,378.01 | Professional | None | $2,951.21 | $17,378.01 | $17,378.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,380.38 Typical High $2,691.53 | Facility | None | $50.12 | $1,380.38 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $7,079.46 | Professional | None | $3,801.89 | $3,801.89 | $7,079.46 |
Fallon Health Setting Facility Modifier None Typical Low $2,818.38 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,818.38 | $3,548.13 | $4,466.84 |
Fallon Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,715.35 Typical High $4,365.16 | Professional | None | $3,235.94 | $3,715.35 | $4,365.16 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,096.48 | $4,073.80 | $14,125.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3,235.94 Median $5,888.44 Typical High $8,709.64 | Professional | None | $3,235.94 | $5,888.44 | $8,709.64 |
Mass General Brigham Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $10,232.93 | Facility | None | $758.58 | $2,884.03 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,818.38 Median $6,606.93 Typical High $19,498.45 | Professional | None | $2,818.38 | $6,606.93 | $19,498.45 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,258.93 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $12,302.69 | Professional | None | $2,884.03 | $4,168.69 | $12,302.69 |
Well Sense Setting Facility Modifier None Typical Low $2,041.74 Median $2,754.23 Typical High $4,168.69 | Facility | None | $2,041.74 | $2,754.23 | $4,168.69 |
Well Sense Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,949.84 | $1,949.84 | $2,630.27 |
8 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 $1,412.54 Median $1,412.54 Typical High $3,715.35 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $1,479.11 | Professional | 53 · Discontinued | $562.34 | $562.34 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $5,623.41 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $1,122.02 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $281.84 Typical High $741.31 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $5,248.07 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,819.70 Median $3,162.28 Typical High $4,168.69 | Professional | 62 · Two surgeons | $1,819.70 | $3,162.28 | $4,168.69 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $467.74 Median $794.33 Typical High $1,071.52 | Professional | 82 · Assistant surgeon, no resident | $467.74 | $794.33 | $1,071.52 |
Where Massachusetts sits
The same service costs 6.3 times more in Maine than in South Carolina. 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 $35,748SC $5,705
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.