How much rates vary
Facilitymedian $1,862 · 10th to 90th $407 to $3,981Professionalmedian $2,884 · 10th to 90th $1,660 to $11,749
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 $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,659.59 | $2,290.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,265.80 | Facility | None | $346.74 | $1,047.13 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,819.70 Median $4,466.84 Typical High $11,748.98 | Professional | None | $1,819.70 | $4,466.84 | $11,748.98 |
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 $2,238.72 Median $2,754.23 Typical High $4,168.69 | Professional | None | $2,238.72 | $2,754.23 | $4,168.69 |
Fallon Health Setting Facility Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,311.31 | Facility | None | $1,778.28 | $2,187.76 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $3,090.30 | Professional | None | $1,949.84 | $2,290.87 | $3,090.30 |
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 $1,949.84 Median $3,630.78 Typical High $5,128.61 | Professional | None | $1,949.84 | $3,630.78 | $5,128.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,265.80 | Facility | None | $346.74 | $1,047.13 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,819.70 Median $4,466.84 Typical High $11,748.98 | Professional | None | $1,819.70 | $4,466.84 | $11,748.98 |
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 $1,819.70 Median $2,398.83 Typical High $7,244.36 | Professional | None | $1,819.70 | $2,398.83 | $7,244.36 |
Well Sense Setting Facility Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,630.27 | Facility | None | $1,288.25 | $1,778.28 | $2,630.27 |
Well Sense Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,230.27 | $1,659.59 |
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 $831.76 Median $831.76 Typical High $1,174.90 | Professional | 52 · Reduced service | $831.76 | $831.76 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $467.74 | Professional | 53 · Discontinued | $331.13 | $331.13 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $354.81 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $234.42 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,659.59 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $1,071.52 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $891.25 Median $891.25 Typical High $1,202.26 | Professional | Q3 · Living kidney donor | $891.25 | $891.25 | $1,202.26 |
Where Massachusetts sits
The same service costs 5.4 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· 13th of 51
$2,754
AK $6,026TX $1,122
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.