How much rates vary
Facilitymedian $794 · 10th to 90th $138 to $3,981Professionalmedian $513 · 10th to 90th $145 to $2,455
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 $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $363.08 Typical High $478.63 | Professional | None | $131.83 | $363.08 | $478.63 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $1,698.24 Typical High $5,011.87 | Facility | None | $331.13 | $1,698.24 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $147.91 Median $602.56 Typical High $3,467.37 | Professional | None | $147.91 | $602.56 | $3,467.37 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $323.59 | Facility | None | $138.04 | $138.04 | $323.59 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $223.87 Median $489.78 Typical High $1,737.80 | Professional | None | $223.87 | $489.78 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $1,819.70 Typical High $2,754.23 | Facility | None | $199.53 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $1,023.29 | Professional | None | $208.93 | $467.74 | $1,023.29 |
Fallon Health Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $3,311.31 | Facility | None | $125.89 | $169.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $977.24 | Professional | None | $616.60 | $724.44 | $977.24 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $144.54 Median $501.19 Typical High $1,318.26 | Professional | None | $144.54 | $501.19 | $1,318.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $1,698.24 Typical High $5,011.87 | Facility | None | $331.13 | $1,698.24 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $147.91 Median $602.56 Typical High $3,467.37 | Professional | None | $147.91 | $602.56 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $144.54 Median $467.74 Typical High $1,288.25 | Professional | None | $144.54 | $467.74 | $1,288.25 |
Well Sense Setting Facility Modifier None Typical Low $114.82 Median $389.05 Typical High $933.25 | Facility | None | $114.82 | $389.05 | $933.25 |
Well Sense Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $398.11 | Professional | None | $93.33 | $141.25 | $398.11 |
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 $66.07 Median $181.97 Typical High $239.88 | Professional | 52 · Reduced service | $66.07 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $72.44 Typical High $95.50 | Professional | 53 · Discontinued | $26.30 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $269.15 Typical High $354.81 | Professional | 54 · Surgery only | $100.00 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $53.70 Typical High $72.44 | Professional | 55 · Aftercare only | $19.95 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $36.31 Typical High $47.86 | Professional | 56 · Pre-op care only | $13.18 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $251.19 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $93.33 | $251.19 | $331.13 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $89.13 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $60.26 | $89.13 | $263.03 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | Q3 · Living kidney donor | $117.49 | $117.49 | $158.49 |
Where Massachusetts sits
The same service costs 5.6 times more in Colorado 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
CO $4,763ND $853
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.