How much rates vary
Facilitymedian $741 · 10th to 90th $110 to $3,631Professionalmedian $170 · 10th to 90th $95 to $891
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $141.25 | Professional | None | $63.10 | $63.10 | $141.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $912.01 Typical High $3,548.13 | Facility | None | $316.23 | $912.01 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $107.15 Median $257.04 Typical High $891.25 | Professional | None | $107.15 | $257.04 | $891.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $177.83 | Professional | None | $95.50 | $95.50 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,318.26 Typical High $1,698.24 | Facility | None | $676.08 | $1,318.26 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $269.15 | Professional | None | $154.88 | $165.96 | $269.15 |
Fallon Health Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $3,311.31 | Facility | None | $95.50 | $125.89 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $165.96 | Professional | None | $104.71 | $123.03 | $165.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $288.40 | Professional | None | $104.71 | $199.53 | $288.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $912.01 Typical High $3,548.13 | Facility | None | $316.23 | $912.01 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $107.15 Median $257.04 Typical High $891.25 | Professional | None | $107.15 | $257.04 | $891.25 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,165.95 | Facility | None | $575.44 | $1,380.38 | $6,165.95 |
United Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $416.87 | Professional | None | $107.15 | $151.36 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $81.28 Median $138.04 Typical High $562.34 | Facility | None | $81.28 | $138.04 | $562.34 |
Well Sense Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | None | $67.61 | $67.61 | $91.20 |
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 $31.62 Median $31.62 Typical High $75.86 | Professional | 52 · Reduced service | $31.62 | $31.62 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $30.20 | Professional | 53 · Discontinued | $12.88 | $12.88 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $114.82 | Professional | 54 · Surgery only | $47.86 | $47.86 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $22.91 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $15.14 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | Q3 · Living kidney donor | $50.12 | $50.12 | $67.61 |
Where Massachusetts sits
The same service costs 14.5 times more in Colorado than in Montana. 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
CO $4,506MT $310
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.