How much rates vary
Facilitymedian $1,349 · 10th to 90th $407 to $3,548Professionalmedian $1,950 · 10th to 90th $1,122 to $7,943
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 $3,019.95 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,019.95 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,122.02 | $1,584.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $891.25 Typical High $3,548.13 | Facility | None | $346.74 | $891.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $7,943.28 | Professional | None | $1,174.90 | $3,090.30 | $7,943.28 |
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 $1,412.54 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,819.70 | $2,754.23 |
Fallon Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $3,311.31 | Facility | None | $1,202.26 | $1,513.56 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,584.89 | $2,137.96 |
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 $1,318.26 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,318.26 | $2,511.89 | $3,467.37 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $891.25 Typical High $3,548.13 | Facility | None | $346.74 | $891.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $7,943.28 | Professional | None | $1,174.90 | $3,090.30 | $7,943.28 |
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 $1,174.90 Median $1,584.89 Typical High $4,466.84 | Professional | None | $1,174.90 | $1,584.89 | $4,466.84 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,737.80 | Facility | None | $851.14 | $1,174.90 | $1,737.80 |
Well Sense Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | None | $794.33 | $794.33 | $1,071.52 |
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 $549.54 Median $549.54 Typical High $794.33 | Professional | 52 · Reduced service | $549.54 | $549.54 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,174.90 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $234.42 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,096.48 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $691.83 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | Q3 · Living kidney donor | $524.81 | $524.81 | $707.95 |
Where Massachusetts sits
The same service costs 5.6 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· 14th of 51
$1,820
AK $4,266TX $759
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.