How much rates vary
Facilitymedian $1,905 · 10th to 90th $347 to $3,631Professionalmedian $3,020 · 10th to 90th $1,738 to $13,804
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 $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,737.80 | $1,737.80 | $2,454.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $1,047.13 Typical High $4,073.80 | Facility | None | $316.23 | $1,047.13 | $4,073.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,819.70 Median $4,677.35 Typical High $13,803.84 | Professional | None | $1,819.70 | $4,677.35 | $13,803.84 |
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 $2,290.87 Median $2,884.03 Typical High $4,265.80 | Professional | None | $2,290.87 | $2,884.03 | $4,265.80 |
Fallon Health Setting Facility Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,311.31 | Facility | None | $1,862.09 | $2,290.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $3,235.94 | Professional | None | $2,041.74 | $2,398.83 | $3,235.94 |
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 $2,041.74 Median $3,801.89 Typical High $5,248.07 | Professional | None | $2,041.74 | $3,801.89 | $5,248.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $1,047.13 Typical High $4,073.80 | Facility | None | $316.23 | $1,047.13 | $4,073.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,819.70 Median $4,677.35 Typical High $13,803.84 | Professional | None | $1,819.70 | $4,677.35 | $13,803.84 |
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 $1,862.09 Median $2,454.71 Typical High $7,079.46 | Professional | None | $1,862.09 | $2,454.71 | $7,079.46 |
Well Sense Setting Facility Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,754.23 | Facility | None | $1,318.26 | $1,778.28 | $2,754.23 |
Well Sense Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,230.27 | $1,659.59 |
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 $870.96 Median $870.96 Typical High $1,230.27 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $489.78 | Professional | 53 · Discontinued | $346.74 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $363.08 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $245.47 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,698.24 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $1,071.52 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $891.25 Median $891.25 Typical High $1,202.26 | Professional | Q3 · Living kidney donor | $891.25 | $891.25 | $1,202.26 |
Where Massachusetts sits
The same service costs 5.4 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· 15th of 51
$2,884
AK $6,310TX $1,175
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.