How much rates vary
Facilitymedian $2,692 · 10th to 90th $407 to $4,365Professionalmedian $4,677 · 10th to 90th $2,754 to $18,197
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 $2,754.23 Median $2,754.23 Typical High $3,890.45 | Professional | None | $2,754.23 | $2,754.23 | $3,890.45 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,456.54 | Facility | None | $346.74 | $1,047.13 | $6,456.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,754.23 Median $6,918.31 Typical High $18,197.01 | Professional | None | $2,754.23 | $6,918.31 | $18,197.01 |
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 $3,467.37 Median $3,467.37 Typical High $6,760.83 | Professional | None | $3,467.37 | $3,467.37 | $6,760.83 |
Fallon Health Setting Facility Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $4,073.80 | Facility | None | $2,691.53 | $3,311.31 | $4,073.80 |
Fallon Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $4,786.30 | Professional | None | $3,019.95 | $3,548.13 | $4,786.30 |
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 $2,951.21 Median $5,495.41 Typical High $8,128.31 | Professional | None | $2,951.21 | $5,495.41 | $8,128.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,456.54 | Facility | None | $346.74 | $1,047.13 | $6,456.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,754.23 Median $6,918.31 Typical High $18,197.01 | Professional | None | $2,754.23 | $6,918.31 | $18,197.01 |
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 $2,818.38 Median $3,801.89 Typical High $10,964.78 | Professional | None | $2,818.38 | $3,801.89 | $10,964.78 |
Well Sense Setting Facility Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $4,265.80 | Facility | None | $2,089.30 | $2,884.03 | $4,265.80 |
Well Sense Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,041.74 | $2,754.23 |
8 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 $1,380.38 Median $1,380.38 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $776.25 | Professional | 53 · Discontinued | $549.54 | $549.54 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $575.44 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $2,691.53 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,737.80 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $1,096.48 Median $1,096.48 Typical High $1,479.11 | Professional | Q3 · Living kidney donor | $1,096.48 | $1,096.48 | $1,479.11 |
Where Massachusetts sits
The same service costs 22.9 times more in Alaska than in Texas. 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· 13th of 51
$4,365
AK $9,120TX $398
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.