How much rates vary
Facilitymedian $2,042 · 10th to 90th $407 to $4,074Professionalmedian $3,311 · 10th to 90th $1,905 to $13,490
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 $5,248.07 | Facility | None | $2,691.53 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,905.46 | $1,905.46 | $2,691.53 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,786.30 | Facility | None | $346.74 | $1,047.13 | $4,786.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,041.74 Median $5,128.61 Typical High $13,489.63 | Professional | None | $2,041.74 | $5,128.61 | $13,489.63 |
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 $2,570.40 Median $3,162.28 Typical High $4,786.30 | Professional | None | $2,570.40 | $3,162.28 | $4,786.30 |
Fallon Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,548.13 | Facility | None | $2,041.74 | $2,511.89 | $3,548.13 |
Fallon Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,238.72 | $2,630.27 | $3,548.13 |
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 $2,238.72 Median $4,168.69 Typical High $5,754.40 | Professional | None | $2,238.72 | $4,168.69 | $5,754.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,786.30 | Facility | None | $346.74 | $1,047.13 | $4,786.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,041.74 Median $5,128.61 Typical High $13,489.63 | Professional | None | $2,041.74 | $5,128.61 | $13,489.63 |
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 $2,041.74 Median $2,691.53 Typical High $8,317.64 | Professional | None | $2,041.74 | $2,691.53 | $8,317.64 |
Well Sense Setting Facility Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $3,019.95 | Facility | None | $1,445.44 | $2,041.74 | $3,019.95 |
Well Sense Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,380.38 | $1,862.09 |
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 $954.99 Median $954.99 Typical High $1,348.96 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $537.03 | Professional | 53 · Discontinued | $380.19 | $380.19 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $407.38 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $269.15 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,905.46 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,202.26 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | Q3 · Living kidney donor | $933.25 | $933.25 | $1,258.93 |
Where Massachusetts sits
The same service costs 6.9 times more in Maine than in Maryland. 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 $18,419MD $2,652
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.