How much rates vary
Facilitymedian $2,692 · 10th to 90th $407 to $4,365Professionalmedian $4,677 · 10th to 90th $2,754 to $19,498
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 $3,801.89 | Professional | None | $2,754.23 | $2,754.23 | $3,801.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,760.83 | Facility | None | $346.74 | $1,047.13 | $6,760.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,570.40 Median $7,413.10 Typical High $19,498.45 | Professional | None | $2,570.40 | $7,413.10 | $19,498.45 |
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 $3,388.44 Median $4,365.16 Typical High $6,760.83 | Professional | None | $3,388.44 | $4,365.16 | $6,760.83 |
Fallon Health Setting Facility Modifier None Typical Low $2,818.38 Median $3,630.78 Typical High $4,365.16 | Facility | None | $2,818.38 | $3,630.78 | $4,365.16 |
Fallon Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $5,128.61 | Professional | None | $3,235.94 | $3,801.89 | $5,128.61 |
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 $3,162.28 Median $6,025.60 Typical High $8,317.64 | Professional | None | $3,162.28 | $6,025.60 | $8,317.64 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,760.83 | Facility | None | $346.74 | $1,047.13 | $6,760.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,570.40 Median $7,413.10 Typical High $19,498.45 | Professional | None | $2,570.40 | $7,413.10 | $19,498.45 |
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 $2,454.71 Median $3,801.89 Typical High $11,481.54 | Professional | None | $2,454.71 | $3,801.89 | $11,481.54 |
Well Sense Setting Facility Modifier None Typical Low $2,041.74 Median $2,754.23 Typical High $4,168.69 | Facility | None | $2,041.74 | $2,754.23 | $4,168.69 |
Well Sense Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,818.38 | Professional | None | $2,089.30 | $2,089.30 | $2,818.38 |
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 $1,905.46 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | 53 · Discontinued | $549.54 | $549.54 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,041.74 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,041.74 | $2,041.74 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,905.46 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,905.46 | $2,630.27 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,778.28 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | Q3 · Living kidney donor | $954.99 | $954.99 | $1,288.25 |
Where Massachusetts sits
The same service costs 5.1 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
$4,467
AK $9,772TX $1,905
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.