How much rates vary
Facilitymedian $1,820 · 10th to 90th $407 to $3,890Professionalmedian $2,884 · 10th to 90th $1,622 to $11,482
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 $1,621.81 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,621.81 | $2,290.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,168.69 | Facility | None | $346.74 | $1,047.13 | $4,168.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,778.28 Median $4,365.16 Typical High $11,481.54 | Professional | None | $1,778.28 | $4,365.16 | $11,481.54 |
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 $2,187.76 Median $2,691.53 Typical High $4,073.80 | Professional | None | $2,187.76 | $2,691.53 | $4,073.80 |
Fallon Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $3,311.31 | Facility | None | $1,737.80 | $2,137.96 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,905.46 | $2,238.72 | $3,019.95 |
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 $1,905.46 Median $3,630.78 Typical High $5,011.87 | Professional | None | $1,905.46 | $3,630.78 | $5,011.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,168.69 | Facility | None | $346.74 | $1,047.13 | $4,168.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,778.28 Median $4,365.16 Typical High $11,481.54 | Professional | None | $1,778.28 | $4,365.16 | $11,481.54 |
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 $1,778.28 Median $2,344.23 Typical High $6,606.93 | Professional | None | $1,778.28 | $2,344.23 | $6,606.93 |
Well Sense Setting Facility Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,570.40 | Facility | None | $1,258.93 | $1,737.80 | $2,570.40 |
Well Sense Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
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 $812.83 Median $812.83 Typical High $1,148.15 | Professional | 52 · Reduced service | $812.83 | $812.83 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $457.09 | Professional | 53 · Discontinued | $323.59 | $323.59 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $346.74 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,621.81 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $1,023.29 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | Q3 · Living kidney donor | $794.33 | $794.33 | $1,071.52 |
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
$2,692
AK $5,888TX $1,096
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.