How much rates vary
Facilitymedian $912 · 10th to 90th $407 to $3,548Professionalmedian $1,148 · 10th to 90th $631 to $4,786
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 $1,698.24 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,698.24 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $870.96 | Professional | None | $575.44 | $575.44 | $870.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $3,548.13 | Facility | None | $346.74 | $741.31 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $707.95 Median $1,819.70 Typical High $4,786.30 | Professional | None | $707.95 | $1,819.70 | $4,786.30 |
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 $831.76 Median $1,096.48 Typical High $1,621.81 | Professional | None | $831.76 | $1,096.48 | $1,621.81 |
Fallon Health Setting Facility Modifier None Typical Low $741.31 Median $933.25 Typical High $3,311.31 | Facility | None | $741.31 | $933.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,318.26 | Professional | None | $831.76 | $977.24 | $1,318.26 |
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 $758.58 Median $1,513.56 Typical High $2,089.30 | Professional | None | $758.58 | $1,513.56 | $2,089.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $3,548.13 | Facility | None | $346.74 | $741.31 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $707.95 Median $1,819.70 Typical High $4,786.30 | Professional | None | $707.95 | $1,819.70 | $4,786.30 |
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 $676.08 Median $912.01 Typical High $2,818.38 | Professional | None | $676.08 | $912.01 | $2,818.38 |
Well Sense Setting Facility Modifier None Typical Low $501.19 Median $676.08 Typical High $1,023.29 | Facility | None | $501.19 | $676.08 | $1,023.29 |
Well Sense Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | None | $436.52 | $436.52 | $588.84 |
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 $288.40 Median $288.40 Typical High $436.52 | Professional | 52 · Reduced service | $288.40 | $288.40 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $177.83 | Professional | 53 · Discontinued | $114.82 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $660.69 | Professional | 54 · Surgery only | $436.52 | $436.52 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $131.83 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $87.10 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $616.60 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $380.19 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $316.23 Median $316.23 Typical High $426.58 | Professional | Q3 · Living kidney donor | $316.23 | $316.23 | $426.58 |
Where Massachusetts sits
The same service costs 5.4 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
$1,122
AK $2,512TX $468
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.