How much rates vary
Facilitymedian $324 · 10th to 90th $95 to $3,548Professionalmedian $170 · 10th to 90th $102 to $1,096
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 $302.00 Median $2,818.38 Typical High $5,128.61 | Facility | None | $302.00 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $158.49 | Professional | None | $102.33 | $102.33 | $158.49 |
AllWays Health Partners Setting Facility Modifier None Typical Low $75.86 Median $724.44 Typical High $3,548.13 | Facility | None | $75.86 | $724.44 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $104.71 Median $263.03 Typical High $1,096.48 | Professional | None | $104.71 | $263.03 | $1,096.48 |
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 $158.49 Median $165.96 Typical High $263.03 | Professional | None | $158.49 | $165.96 | $263.03 |
Fallon Health Setting Facility Modifier None Typical Low $95.50 Median $128.82 Typical High $3,311.31 | Facility | None | $95.50 | $128.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $177.83 | Professional | None | $114.82 | $134.90 | $177.83 |
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 $114.82 Median $213.80 Typical High $295.12 | Professional | None | $114.82 | $213.80 | $295.12 |
Mass General Brigham Setting Facility Modifier None Typical Low $75.86 Median $724.44 Typical High $3,548.13 | Facility | None | $75.86 | $724.44 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $104.71 Median $263.03 Typical High $1,096.48 | Professional | None | $104.71 | $263.03 | $1,096.48 |
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 $112.20 Median $144.54 Typical High $436.52 | Professional | None | $112.20 | $144.54 | $436.52 |
Well Sense Setting Facility Modifier None Typical Low $77.62 Median $107.15 Typical High $158.49 | Facility | None | $77.62 | $107.15 | $158.49 |
Well Sense Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $104.71 | Professional | None | $77.62 | $77.62 | $104.71 |
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 $51.29 Median $51.29 Typical High $70.79 | Professional | 52 · Reduced service | $51.29 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $20.42 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | 54 · Surgery only | $75.86 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $14.13 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | 78 · Unplanned return to OR | $50.12 | $50.12 | $67.61 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | Q3 · Living kidney donor | $60.26 | $60.26 | $81.28 |
Where Massachusetts sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$174
AK $427NJ $97.72
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.