How much rates vary
Facilitymedian $1,047 · 10th to 90th $407 to $3,548Professionalmedian $1,514 · 10th to 90th $851 to $6,166
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 $2,344.23 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,344.23 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Professional | None | $851.14 | $851.14 | $1,202.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $776.25 Typical High $3,548.13 | Facility | None | $346.74 | $776.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $891.25 Median $2,344.23 Typical High $6,165.95 | Professional | None | $891.25 | $2,344.23 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $446.68 Typical High $954.99 | Facility | None | $50.12 | $446.68 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,412.54 | $2,137.96 |
Fallon Health Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $3,311.31 | Facility | None | $831.76 | $1,148.15 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,202.26 | $1,621.81 |
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 $1,000.00 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,905.46 | $2,630.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $776.25 Typical High $3,548.13 | Facility | None | $346.74 | $776.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $891.25 Median $2,344.23 Typical High $6,165.95 | Professional | None | $891.25 | $2,344.23 | $6,165.95 |
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 $891.25 Median $1,202.26 Typical High $3,715.35 | Professional | None | $891.25 | $1,202.26 | $3,715.35 |
Well Sense Setting Facility Modifier None Typical Low $660.69 Median $912.01 Typical High $1,348.96 | Facility | None | $660.69 | $912.01 | $1,348.96 |
Well Sense Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | None | $616.60 | $616.60 | $831.76 |
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 $426.58 Median $426.58 Typical High $602.56 | Professional | 52 · Reduced service | $426.58 | $426.58 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $239.88 | Professional | 53 · Discontinued | $169.82 | $169.82 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $891.25 | Professional | 54 · Surgery only | $630.96 | $630.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $120.23 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $831.76 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $537.03 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $380.19 Median $380.19 Typical High $512.86 | Professional | Q3 · Living kidney donor | $380.19 | $380.19 | $512.86 |
Where Massachusetts sits
The same service costs 11.4 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 $16,997MD $1,496
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.