How much rates vary
Facilitymedian $490 · 10th to 90th $107 to $3,311Professionalmedian $372 · 10th to 90th $120 to $1,738
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 $537.03 Median $2,238.72 Typical High $3,630.78 | Facility | None | $537.03 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $363.08 Typical High $575.44 | Professional | None | $123.03 | $363.08 | $575.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $3,162.28 | Facility | None | $323.59 | $870.96 | $3,162.28 |
AllWays Health Partners Setting Professional Modifier None Typical Low $120.23 Median $426.58 Typical High $2,570.40 | Professional | None | $120.23 | $426.58 | $2,570.40 |
BCBS Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $389.05 | Facility | None | $169.82 | $208.93 | $389.05 |
BCBS Setting Professional Modifier None Typical Low $169.82 Median $416.87 Typical High $724.44 | Professional | None | $169.82 | $416.87 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $1,000.00 | Facility | None | $446.68 | $676.08 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $316.23 Typical High $707.95 | Professional | None | $141.25 | $316.23 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $3,311.31 | Facility | None | $91.20 | $120.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $741.31 | Professional | None | $467.74 | $549.54 | $741.31 |
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 $100.00 Median $354.81 Typical High $977.24 | Professional | None | $100.00 | $354.81 | $977.24 |
Health New England Setting Facility Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,905.46 | Facility | None | $870.96 | $1,174.90 | $1,905.46 |
Health New England Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $3,162.28 | Facility | None | $323.59 | $870.96 | $3,162.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $120.23 Median $426.58 Typical High $2,570.40 | Professional | None | $120.23 | $426.58 | $2,570.40 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $5,128.61 | Facility | None | $575.44 | $1,380.38 | $5,128.61 |
United Setting Professional Modifier None Typical Low $109.65 Median $331.13 Typical High $891.25 | Professional | None | $109.65 | $331.13 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $79.43 Median $269.15 Typical High $426.58 | Facility | None | $79.43 | $269.15 | $426.58 |
Well Sense Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $316.23 | Professional | None | $91.20 | $138.04 | $316.23 |
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 $61.66 Median $177.83 Typical High $186.21 | Professional | 52 · Reduced service | $61.66 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $72.44 Typical High $74.13 | Professional | 53 · Discontinued | $25.12 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $269.15 Typical High $275.42 | Professional | 54 · Surgery only | $93.33 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $53.70 Typical High $56.23 | Professional | 55 · Aftercare only | $18.62 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $36.31 Typical High $37.15 | Professional | 56 · Pre-op care only | $12.30 | $36.31 | $37.15 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $89.13 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $58.88 | $89.13 | $208.93 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $123.03 Median $123.03 Typical High $165.96 | Professional | Q3 · Living kidney donor | $123.03 | $123.03 | $165.96 |
Where Massachusetts sits
The same service costs 5.1 times more in Connecticut than in North Dakota. 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
CT $3,107ND $611
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.