How much rates vary
Facilitymedian $2,188 · 10th to 90th $407 to $4,074Professionalmedian $3,631 · 10th to 90th $2,042 to $14,454
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 $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,041.74 | $2,884.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,128.61 | Facility | None | $346.74 | $1,047.13 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,137.96 Median $5,495.41 Typical High $14,454.40 | Professional | None | $2,137.96 | $5,495.41 | $14,454.40 |
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 $2,691.53 Median $3,388.44 Typical High $5,011.87 | Professional | None | $2,691.53 | $3,388.44 | $5,011.87 |
Fallon Health Setting Facility Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $3,630.78 | Facility | None | $2,187.76 | $2,691.53 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,398.83 | $2,818.38 | $3,801.89 |
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 $2,398.83 Median $4,466.84 Typical High $6,309.57 | Professional | None | $2,398.83 | $4,466.84 | $6,309.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,128.61 | Facility | None | $346.74 | $1,047.13 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,137.96 Median $5,495.41 Typical High $14,454.40 | Professional | None | $2,137.96 | $5,495.41 | $14,454.40 |
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 $2,137.96 Median $2,884.03 Typical High $8,317.64 | Professional | None | $2,137.96 | $2,884.03 | $8,317.64 |
Well Sense Setting Facility Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $3,235.94 | Facility | None | $1,584.89 | $2,137.96 | $3,235.94 |
Well Sense Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,479.11 | $2,041.74 |
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 $1,023.29 Median $1,023.29 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $575.44 | Professional | 53 · Discontinued | $407.38 | $407.38 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $436.52 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $288.40 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $2,041.74 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,288.25 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | Q3 · Living kidney donor | $741.31 | $741.31 | $1,000.00 |
Where Massachusetts sits
The same service costs 7.6 times more in Maine 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.
Physician feeFacility fee
ME $18,667TX $2,469
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.