How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,096 to $10,715Professionalmedian $2,138 · 10th to 90th $1,202 to $8,511
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 $1,949.84 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,235.94 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,202.26 | $1,698.24 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,318.26 Median $4,365.16 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,365.16 | $14,125.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $8,511.38 | Professional | None | $1,288.25 | $3,311.31 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $6,456.54 Typical High $9,772.37 | Facility | None | $446.68 | $6,456.54 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,659.59 | $1,995.26 | $2,951.21 |
Fallon Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $3,311.31 | Facility | None | $1,202.26 | $1,621.81 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,698.24 | $2,290.87 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,096.48 | $4,073.80 | $14,125.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,412.54 Median $2,691.53 Typical High $3,890.45 | Professional | None | $1,412.54 | $2,691.53 | $3,890.45 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,318.26 Median $4,365.16 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,365.16 | $14,125.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $8,511.38 | Professional | None | $1,288.25 | $3,311.31 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $25,703.96 | Facility | None | $1,258.93 | $4,073.80 | $25,703.96 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $5,248.07 | Professional | None | $1,288.25 | $1,737.80 | $5,248.07 |
Well Sense Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,905.46 | Facility | None | $933.25 | $1,258.93 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,202.26 | Professional | None | $891.25 | $891.25 | $1,202.26 |
7 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 $602.56 Median $602.56 Typical High $851.14 | Professional | 52 · Reduced service | $602.56 | $602.56 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $338.84 | Professional | 53 · Discontinued | $239.88 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $257.04 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $169.82 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,202.26 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | Q3 · Living kidney donor | $489.78 | $489.78 | $660.69 |
Where Massachusetts sits
The same service costs 25.7 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· 11th of 51
$2,239
AK $5,129TX $200
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.