How much rates vary
Facilitymedian $3,162 · 10th to 90th $407 to $5,888Professionalmedian $6,457 · 10th to 90th $3,631 to $29,512
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 $3,388.44 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,388.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $5,248.07 | Professional | None | $3,388.44 | $3,388.44 | $5,248.07 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $8,709.64 | Facility | None | $346.74 | $1,047.13 | $8,709.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,890.45 Median $10,000.00 Typical High $29,512.09 | Professional | None | $3,890.45 | $10,000.00 | $29,512.09 |
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 $4,786.30 Median $6,165.95 Typical High $9,120.11 | Professional | None | $4,786.30 | $6,165.95 | $9,120.11 |
Fallon Health Setting Facility Modifier None Typical Low $3,311.31 Median $4,897.79 Typical High $5,888.44 | Facility | None | $3,311.31 | $4,897.79 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $6,918.31 | Professional | None | $4,365.16 | $5,128.61 | $6,918.31 |
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 $4,365.16 Median $8,317.64 Typical High $11,748.98 | Professional | None | $4,365.16 | $8,317.64 | $11,748.98 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $8,709.64 | Facility | None | $346.74 | $1,047.13 | $8,709.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,890.45 Median $10,000.00 Typical High $29,512.09 | Professional | None | $3,890.45 | $10,000.00 | $29,512.09 |
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 $3,890.45 Median $5,248.07 Typical High $15,135.61 | Professional | None | $3,890.45 | $5,248.07 | $15,135.61 |
Well Sense Setting Facility Modifier None Typical Low $2,818.38 Median $3,981.07 Typical High $5,888.44 | Facility | None | $2,818.38 | $3,981.07 | $5,888.44 |
Well Sense Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
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 $1,698.24 Median $1,698.24 Typical High $2,630.27 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $1,047.13 | Professional | 53 · Discontinued | $676.08 | $676.08 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,570.40 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,570.40 | $2,570.40 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $512.86 Typical High $794.33 | Professional | 55 · Aftercare only | $512.86 | $512.86 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $524.81 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,398.83 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,398.83 | $3,715.35 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $2,238.72 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $1,380.38 Median $1,380.38 Typical High $1,862.09 | Professional | Q3 · Living kidney donor | $1,380.38 | $1,380.38 | $1,862.09 |
Where Massachusetts sits
The same service costs 21.9 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· 14th of 51
$6,166
AK $13,183TX $603
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.