How much rates vary
Facilitymedian $309 · 10th to 90th $123 to $2,239Professionalmedian $224 · 10th to 90th $120 to $1,778
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $186.21 | Professional | None | $83.18 | $83.18 | $186.21 |
AllWays Health Partners Setting Facility Modifier None Typical Low $134.90 Median $467.74 Typical High $1,862.09 | Facility | None | $134.90 | $467.74 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $138.04 Median $309.03 Typical High $1,778.28 | Professional | None | $138.04 | $309.03 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $524.81 | Facility | None | $371.54 | $446.68 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $309.03 | Professional | None | $190.55 | $190.55 | $309.03 |
Fallon Health Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $933.25 | Facility | None | $123.03 | $151.36 | $933.25 |
Fallon Health Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $213.80 | Professional | None | $134.90 | $158.49 | $213.80 |
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 $138.04 Median $257.04 Typical High $380.19 | Professional | None | $138.04 | $257.04 | $380.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $134.90 Median $467.74 Typical High $1,862.09 | Facility | None | $134.90 | $467.74 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $138.04 Median $309.03 Typical High $1,778.28 | Professional | None | $138.04 | $309.03 | $1,778.28 |
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 $134.90 Median $181.97 Typical High $467.74 | Professional | None | $134.90 | $181.97 | $467.74 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $134.90 Typical High $204.17 | Facility | None | $97.72 | $134.90 | $204.17 |
Well Sense Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
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 $40.74 Median $40.74 Typical High $95.50 | Professional | 52 · Reduced service | $40.74 | $40.74 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $38.02 | Professional | 53 · Discontinued | $16.60 | $16.60 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $141.25 | Professional | 54 · Surgery only | $61.66 | $61.66 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $28.18 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $19.05 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $60.26 | $60.26 | $81.28 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | Q3 · Living kidney donor | $93.33 | $93.33 | $125.89 |
Where Massachusetts sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 9th of 51
$229
AK $501UT $97.72
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.