How much rates vary
Facilitymedian $295 · 10th to 90th $52 to $2,399Professionalmedian $87 · 10th to 90th $47 to $501
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 $537.03 Median $2,238.72 Typical High $3,630.78 | Facility | None | $537.03 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $87.10 | Professional | None | $36.31 | $36.31 | $87.10 |
AllWays Health Partners Setting Facility Modifier None Typical Low $114.82 Median $467.74 Typical High $1,862.09 | Facility | None | $114.82 | $467.74 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $54.95 Median $120.23 Typical High $501.19 | Professional | None | $54.95 | $120.23 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $446.68 Typical High $524.81 | Facility | None | $199.53 | $446.68 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $123.03 | Professional | None | $77.62 | $77.62 | $123.03 |
Fallon Health Setting Facility Modifier None Typical Low $48.98 Median $61.66 Typical High $3,311.31 | Facility | None | $48.98 | $61.66 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $81.28 | Professional | None | $51.29 | $60.26 | $81.28 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $141.25 | Professional | None | $51.29 | $97.72 | $141.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $114.82 Median $467.74 Typical High $1,862.09 | Facility | None | $114.82 | $467.74 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $54.95 Median $120.23 Typical High $501.19 | Professional | None | $54.95 | $120.23 | $501.19 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $194.98 | Professional | None | $53.70 | $74.13 | $194.98 |
Well Sense Setting Facility Modifier None Typical Low $40.74 Median $72.44 Typical High $165.96 | Facility | None | $40.74 | $72.44 | $165.96 |
Well Sense Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
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 $18.20 Median $18.20 Typical High $38.90 | Professional | 52 · Reduced service | $18.20 | $18.20 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $15.49 | Professional | 53 · Discontinued | $7.24 | $7.24 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $26.92 Typical High $58.88 | Professional | 54 · Surgery only | $26.92 | $26.92 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $11.75 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $7.76 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | 78 · Unplanned return to OR | $25.70 | $25.70 | $34.67 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | Q3 · Living kidney donor | $40.74 | $40.74 | $54.95 |
Where Massachusetts sits
The same service costs 4.2 times more in Alaska than in Florida. 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.
Massachusetts· 12th of 51
$89.13
AK $200FL $47.86
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.