How much rates vary
Facilitymedian $955 · 10th to 90th $324 to $3,548Professionalmedian $1,318 · 10th to 90th $741 to $5,248
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 $2,041.74 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,041.74 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,047.13 | Professional | None | $707.95 | $707.95 | $1,047.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $776.25 Typical High $3,548.13 | Facility | None | $323.59 | $776.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $812.83 Median $2,041.74 Typical High $5,248.07 | Professional | None | $812.83 | $2,041.74 | $5,248.07 |
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 $1,000.00 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,230.27 | $1,819.70 |
Fallon Health Setting Facility Modifier None Typical Low $812.83 Median $1,023.29 Typical High $3,311.31 | Facility | None | $812.83 | $1,023.29 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $891.25 | $1,047.13 | $1,412.54 |
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 $870.96 Median $1,659.59 Typical High $2,290.87 | Professional | None | $870.96 | $1,659.59 | $2,290.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $776.25 Typical High $3,548.13 | Facility | None | $323.59 | $776.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $812.83 Median $2,041.74 Typical High $5,248.07 | Professional | None | $812.83 | $2,041.74 | $5,248.07 |
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 $794.33 Median $1,071.52 Typical High $3,019.95 | Professional | None | $794.33 | $1,071.52 | $3,019.95 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $1,174.90 | Facility | None | $562.34 | $758.58 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | None | $524.81 | $524.81 | $707.95 |
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 $354.81 Median $354.81 Typical High $524.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $208.93 | Professional | 53 · Discontinued | $141.25 | $141.25 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $776.25 | Professional | 54 · Surgery only | $537.03 | $537.03 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $158.49 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $104.71 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $724.44 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $457.09 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | Q3 · Living kidney donor | $389.05 | $389.05 | $524.81 |
Where Massachusetts sits
The same service costs 12.3 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 $16,849MD $1,375
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.