How much rates vary
Facilitymedian $933 · 10th to 90th $407 to $3,631Professionalmedian $646 · 10th to 90th $398 to $3,548
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 $398.11 Median $398.11 Typical High $575.44 | Professional | None | $398.11 | $398.11 | $575.44 |
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 $416.87 Median $933.25 Typical High $3,548.13 | Professional | None | $416.87 | $933.25 | $3,548.13 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $794.33 | Professional | None | $371.54 | $371.54 | $794.33 |
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 $549.54 Median $602.56 Typical High $912.01 | Professional | None | $549.54 | $602.56 | $912.01 |
Fallon Health Setting Facility Modifier None Typical Low $371.54 Median $478.63 Typical High $3,311.31 | Facility | None | $371.54 | $478.63 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $645.65 | Professional | None | $407.38 | $478.63 | $645.65 |
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 $407.38 Median $758.58 Typical High $1,122.02 | Professional | None | $407.38 | $758.58 | $1,122.02 |
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 $416.87 Median $933.25 Typical High $3,548.13 | Professional | None | $416.87 | $933.25 | $3,548.13 |
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 $416.87 Median $549.54 Typical High $1,548.82 | Professional | None | $416.87 | $549.54 | $1,548.82 |
Well Sense Setting Facility Modifier None Typical Low $309.03 Median $416.87 Typical High $645.65 | Facility | None | $309.03 | $416.87 | $645.65 |
Well Sense Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
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 $194.98 Median $194.98 Typical High $263.03 | Professional | 52 · Reduced service | $194.98 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 53 · Discontinued | $79.43 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | 54 · Surgery only | $295.12 | $295.12 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $52.48 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $263.03 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $251.19 Median $251.19 Typical High $338.84 | Professional | Q3 · Living kidney donor | $251.19 | $251.19 | $338.84 |
Where Massachusetts sits
The same service costs 3.8 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 $4,403DE $1,156
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.