How much rates vary
Facilitymedian $1,905 · 10th to 90th $407 to $3,715Professionalmedian $2,818 · 10th to 90th $1,862 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 $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 $1,862.09 Median $1,862.09 Typical High $5,011.87 | Professional | None | $1,862.09 | $1,862.09 | $5,011.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,466.84 | Facility | None | $346.74 | $1,047.13 | $4,466.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,862.09 Median $4,265.80 Typical High $12,589.25 | Professional | None | $1,862.09 | $4,265.80 | $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 $2,511.89 Median $2,511.89 Typical High $4,677.35 | Professional | None | $2,511.89 | $2,511.89 | $4,677.35 |
Fallon Health Setting Facility Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,311.31 | Facility | None | $1,905.46 | $2,344.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $2,818.38 | Professional | None | $2,137.96 | $2,454.71 | $2,818.38 |
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 $2,089.30 Median $3,801.89 Typical High $5,623.41 | Professional | None | $2,089.30 | $3,801.89 | $5,623.41 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,466.84 | Facility | None | $346.74 | $1,047.13 | $4,466.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,862.09 Median $4,265.80 Typical High $12,589.25 | Professional | None | $1,862.09 | $4,265.80 | $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 $1,905.46 Median $2,754.23 Typical High $8,128.31 | Professional | None | $1,905.46 | $2,754.23 | $8,128.31 |
Well Sense Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,754.23 | Facility | None | $1,348.96 | $1,862.09 | $2,754.23 |
Well Sense Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,288.25 | $1,737.80 |
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 $933.25 Median $933.25 Typical High $2,511.89 | Professional | 52 · Reduced service | $933.25 | $933.25 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $1,000.00 | Professional | 53 · Discontinued | $371.54 | $371.54 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $741.31 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $501.19 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $3,467.37 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | 62 · Two surgeons | $7,079.46 | $7,079.46 | $7,079.46 |
Where Massachusetts sits
The same service costs 14.4 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 $34,547MD $2,395
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.