How much rates vary
Facilitymedian $1,096 · 10th to 90th $490 to $4,677Professionalmedian $871 · 10th to 90th $513 to $3,311
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 $1,778.28 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $758.58 | Professional | None | $512.86 | $512.86 | $758.58 |
AllWays Health Partners Setting Facility Modifier None Typical Low $489.78 Median $1,380.38 Typical High $5,011.87 | Facility | None | $489.78 | $1,380.38 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $575.44 Median $1,258.93 Typical High $3,311.31 | Professional | None | $575.44 | $1,258.93 | $3,311.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,659.59 | Professional | None | $691.83 | $691.83 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,949.84 Typical High $2,818.38 | Facility | None | $446.68 | $1,949.84 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,230.27 | Professional | None | $645.65 | $645.65 | $1,230.27 |
Fallon Health Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $3,311.31 | Facility | None | $501.19 | $645.65 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $870.96 | Professional | None | $549.54 | $645.65 | $870.96 |
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 $537.03 Median $1,000.00 Typical High $1,479.11 | Professional | None | $537.03 | $1,000.00 | $1,479.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $489.78 Median $1,380.38 Typical High $5,011.87 | Facility | None | $489.78 | $1,380.38 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $575.44 Median $1,258.93 Typical High $3,311.31 | Professional | None | $575.44 | $1,258.93 | $3,311.31 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $8,709.64 | Facility | None | $575.44 | $1,380.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $2,041.74 | Professional | None | $537.03 | $741.31 | $2,041.74 |
Well Sense Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $891.25 | Facility | None | $426.58 | $575.44 | $891.25 |
Well Sense Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $512.86 | Professional | None | $380.19 | $380.19 | $512.86 |
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 $257.04 Median $257.04 Typical High $346.74 | Professional | 52 · Reduced service | $257.04 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | 53 · Discontinued | $102.33 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | 54 · Surgery only | $380.19 | $380.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $489.78 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $323.59 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | Q3 · Living kidney donor | $275.42 | $275.42 | $371.54 |
Where Massachusetts sits
The same service costs 3.9 times more in Colorado than in Delaware. 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 $5,057DE $1,284
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.