How much rates vary
Facilitymedian $1,778 · 10th to 90th $407 to $3,715Professionalmedian $2,818 · 10th to 90th $1,585 to $11,220
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 $1,584.89 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,584.89 | $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 $1,659.59 Median $4,365.16 Typical High $11,220.18 | Professional | None | $1,659.59 | $4,365.16 | $11,220.18 |
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 $2,041.74 Median $2,630.27 Typical High $3,981.07 | Professional | None | $2,041.74 | $2,630.27 | $3,981.07 |
Fallon Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $3,311.31 | Facility | None | $1,548.82 | $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 $1,862.09 Median $3,548.13 Typical High $5,011.87 | Professional | None | $1,862.09 | $3,548.13 | $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 $1,659.59 Median $4,365.16 Typical High $11,220.18 | Professional | None | $1,659.59 | $4,365.16 | $11,220.18 |
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 $1,659.59 Median $2,238.72 Typical High $6,918.31 | Professional | None | $1,659.59 | $2,238.72 | $6,918.31 |
Well Sense Setting Facility Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,698.24 | $2,511.89 |
Well Sense Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,122.02 | $1,513.56 |
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 $794.33 Median $794.33 Typical High $1,122.02 | Professional | 52 · Reduced service | $794.33 | $794.33 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $457.09 | Professional | 53 · Discontinued | $316.23 | $316.23 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $338.84 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $229.09 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,584.89 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $977.24 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | Q3 · Living kidney donor | $724.44 | $724.44 | $977.24 |
Where Massachusetts sits
The same service costs 20.4 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· 13th of 51
$2,630
AK $5,495TX $269
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.