How much rates vary
Facilitymedian $1,380 · 10th to 90th $407 to $3,548Professionalmedian $2,042 · 10th to 90th $1,148 to $8,318
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 $1,148.15 Median $1,148.15 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,148.15 | $1,659.59 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $933.25 Typical High $3,548.13 | Facility | None | $346.74 | $933.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,202.26 Median $3,235.94 Typical High $8,317.64 | Professional | None | $1,202.26 | $3,235.94 | $8,317.64 |
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 $1,479.11 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,949.84 | $2,884.03 |
Fallon Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $3,311.31 | Facility | None | $1,148.15 | $1,548.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,659.59 | $2,187.76 |
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 $1,380.38 Median $2,570.40 Typical High $3,548.13 | Professional | None | $1,380.38 | $2,570.40 | $3,548.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $933.25 Typical High $3,548.13 | Facility | None | $346.74 | $933.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,202.26 Median $3,235.94 Typical High $8,317.64 | Professional | None | $1,202.26 | $3,235.94 | $8,317.64 |
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 $1,202.26 Median $1,659.59 Typical High $4,677.35 | Professional | None | $1,202.26 | $1,659.59 | $4,677.35 |
Well Sense Setting Facility Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,819.70 | Facility | None | $891.25 | $1,230.27 | $1,819.70 |
Well Sense Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
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 $575.44 Median $575.44 Typical High $831.76 | Professional | 52 · Reduced service | $575.44 | $575.44 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $331.13 | Professional | 53 · Discontinued | $234.42 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,230.27 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $245.47 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,148.15 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $724.44 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | Q3 · Living kidney donor | $436.52 | $436.52 | $588.84 |
Where Massachusetts sits
The same service costs 5.9 times more in Alabama than in Maryland. 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
AL $10,682MD $1,821
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.