How much rates vary
Facilitymedian $2,512 · 10th to 90th $479 to $4,365Professionalmedian $4,365 · 10th to 90th $2,291 to $17,783
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 $7,585.78 | Professional | None | $2,290.87 | $2,290.87 | $7,585.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $6,309.57 | Facility | None | $346.74 | $1,023.29 | $6,309.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,570.40 Median $7,244.36 Typical High $17,782.79 | Professional | None | $2,570.40 | $7,244.36 | $17,782.79 |
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 $3,388.44 Median $3,388.44 Typical High $8,128.31 | Professional | None | $3,388.44 | $3,388.44 | $8,128.31 |
Fallon Health Setting Facility Modifier None Typical Low $2,344.23 Median $3,235.94 Typical High $4,265.80 | Facility | None | $2,344.23 | $3,235.94 | $4,265.80 |
Fallon Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $4,168.69 | Professional | None | $2,884.03 | $3,388.44 | $4,168.69 |
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 $2,884.03 Median $5,248.07 Typical High $7,762.47 | Professional | None | $2,884.03 | $5,248.07 | $7,762.47 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $6,309.57 | Facility | None | $346.74 | $1,023.29 | $6,309.57 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,570.40 Median $7,244.36 Typical High $17,782.79 | Professional | None | $2,570.40 | $7,244.36 | $17,782.79 |
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 $2,884.03 Median $4,073.80 Typical High $9,120.11 | Professional | None | $2,884.03 | $4,073.80 | $9,120.11 |
Well Sense Setting Facility Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $4,168.69 | Facility | None | $2,041.74 | $2,818.38 | $4,168.69 |
Well Sense Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
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 $1,148.15 Median $1,148.15 Typical High $3,801.89 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $1,513.56 | Professional | 53 · Discontinued | $457.09 | $457.09 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $5,754.40 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $1,148.15 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $758.58 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $5,370.32 |
Where Massachusetts sits
The same service costs 10.4 times more in Maine than in Washington. 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 $30,463WA $2,927
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.