How much rates vary
Facilitymedian $1,585 · 10th to 90th $309 to $7,079Professionalmedian $501 · 10th to 90th $302 to $2,138
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 $1,778.28 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $446.68 | Professional | None | $302.00 | $302.00 | $446.68 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,398.83 Typical High $7,244.36 | Facility | None | $549.54 | $2,398.83 | $7,244.36 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $2,137.96 | Professional | None | $309.03 | $691.83 | $2,137.96 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,187.76 | Professional | None | $691.83 | $691.83 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,265.80 Typical High $6,456.54 | Facility | None | $676.08 | $4,265.80 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $676.08 | Professional | None | $398.11 | $426.58 | $676.08 |
Fallon Health Setting Facility Modifier None Typical Low $275.42 Median $354.81 Typical High $3,311.31 | Facility | None | $275.42 | $354.81 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $478.63 | Professional | None | $302.00 | $354.81 | $478.63 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $302.00 Median $575.44 Typical High $831.76 | Professional | None | $302.00 | $575.44 | $831.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,398.83 Typical High $7,244.36 | Facility | None | $549.54 | $2,398.83 | $7,244.36 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $2,137.96 | Professional | None | $309.03 | $691.83 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $15,488.17 | Facility | None | $1,071.52 | $3,890.45 | $15,488.17 |
United Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $1,122.02 | Professional | None | $295.12 | $426.58 | $1,122.02 |
Well Sense Setting Facility Modifier None Typical Low $218.78 Median $389.05 Typical High $1,174.90 | Facility | None | $218.78 | $389.05 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | None | $245.47 | $245.47 | $331.13 |
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 $151.36 Median $151.36 Typical High $204.17 | Professional | 52 · Reduced service | $151.36 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | 53 · Discontinued | $60.26 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $309.03 | Professional | 54 · Surgery only | $229.09 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $61.66 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $40.74 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $40.74 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $208.93 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | Q3 · Living kidney donor | $204.17 | $204.17 | $275.42 |
Where Massachusetts sits
The same service costs 10.4 times more in Wyoming than in Montana. 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
WY $8,979MT $863
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.