How much rates vary
Facilitymedian $871 · 10th to 90th $316 to $3,631Professionalmedian $479 · 10th to 90th $288 to $2,344
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $602.56 | Professional | None | $288.40 | $288.40 | $602.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $3,630.78 | Facility | None | $446.68 | $1,148.15 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $2,344.23 | Professional | None | $309.03 | $691.83 | $2,344.23 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $602.56 | Professional | None | $275.42 | $275.42 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,174.90 Typical High $1,737.80 | Facility | None | $446.68 | $1,174.90 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $707.95 | Professional | None | $426.58 | $446.68 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $275.42 Median $354.81 Typical High $3,311.31 | Facility | None | $275.42 | $354.81 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $478.63 | Professional | None | $302.00 | $354.81 | $478.63 |
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 $302.00 Median $562.34 Typical High $831.76 | Professional | None | $302.00 | $562.34 | $831.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $3,630.78 | Facility | None | $446.68 | $1,148.15 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $2,344.23 | Professional | None | $309.03 | $691.83 | $2,344.23 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $1,148.15 | Professional | None | $302.00 | $407.38 | $1,148.15 |
Well Sense Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $562.34 | Facility | None | $229.09 | $371.54 | $562.34 |
Well Sense Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $302.00 | Professional | None | $223.87 | $223.87 | $302.00 |
7 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 $144.54 Median $144.54 Typical High $194.98 | Professional | 52 · Reduced service | $144.54 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | 53 · Discontinued | $58.88 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | 54 · Surgery only | $218.78 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $58.88 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $38.90 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $194.98 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $190.55 Median $190.55 Typical High $257.04 | Professional | Q3 · Living kidney donor | $190.55 | $190.55 | $257.04 |
Where Massachusetts sits
The same service costs 5.2 times more in Oklahoma than in Montana. 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
OK $4,508MT $873
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.