How much rates vary
Facilitymedian $1,585 · 10th to 90th $372 to $6,607Professionalmedian $589 · 10th to 90th $363 to $2,512
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 $363.08 Median $363.08 Typical High $537.03 | Professional | None | $363.08 | $363.08 | $537.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $524.81 Median $2,398.83 Typical High $6,606.93 | Facility | None | $524.81 | $2,398.83 | $6,606.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $363.08 Median $812.83 Typical High $2,511.89 | Professional | None | $363.08 | $812.83 | $2,511.89 |
BCBS 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 $5,370.32 Typical High $8,128.31 | Facility | None | $676.08 | $5,370.32 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $794.33 | Professional | None | $467.74 | $501.19 | $794.33 |
Fallon Health Setting Facility Modifier None Typical Low $331.13 Median $416.87 Typical High $3,311.31 | Facility | None | $331.13 | $416.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $562.34 | Professional | None | $354.81 | $416.87 | $562.34 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $676.08 Typical High $1,000.00 | Professional | None | $363.08 | $676.08 | $1,000.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $524.81 Median $2,398.83 Typical High $6,606.93 | Facility | None | $524.81 | $2,398.83 | $6,606.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $363.08 Median $812.83 Typical High $2,511.89 | Professional | None | $363.08 | $812.83 | $2,511.89 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $12,302.69 | Facility | None | $851.14 | $2,818.38 | $12,302.69 |
United Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $1,318.26 | Professional | None | $354.81 | $501.19 | $1,318.26 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $467.74 Typical High $1,174.90 | Facility | None | $263.03 | $467.74 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Professional | None | $288.40 | $288.40 | $389.05 |
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 $181.97 Median $181.97 Typical High $239.88 | Professional | 52 · Reduced service | $181.97 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | 53 · Discontinued | $72.44 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | 54 · Surgery only | $269.15 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $48.98 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $251.19 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | Q3 · Living kidney donor | $218.78 | $218.78 | $295.12 |
Where Massachusetts sits
The same service costs 7.2 times more in Wisconsin 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
WI $7,422MT $1,038
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.