How much rates vary
Facilitymedian $234 · 10th to 90th $115 to $2,239Professionalmedian $309 · 10th to 90th $135 to $1,259
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $346.74 | Professional | None | $128.82 | $239.88 | $346.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $323.59 Typical High $1,862.09 | Facility | None | $87.10 | $323.59 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $1,737.80 | Professional | None | $144.54 | $338.84 | $1,737.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $295.12 | Facility | None | $128.82 | $158.49 | $295.12 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | None | $151.36 | $151.36 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $281.84 Typical High $489.78 | Facility | None | $194.98 | $281.84 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $549.54 | Professional | None | $154.88 | $302.00 | $549.54 |
Fallon Health Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $3,311.31 | Facility | None | $125.89 | $169.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $489.78 | Professional | None | $309.03 | $363.08 | $489.78 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $660.69 | Professional | None | $134.90 | $302.00 | $660.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $323.59 Typical High $1,862.09 | Facility | None | $87.10 | $323.59 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $1,737.80 | Professional | None | $144.54 | $338.84 | $1,737.80 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $134.90 Median $275.42 Typical High $660.69 | Professional | None | $134.90 | $275.42 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $147.91 Typical High $288.40 | Facility | None | $87.10 | $147.91 | $288.40 |
Well Sense Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $199.53 | Professional | None | $93.33 | $141.25 | $199.53 |
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 $64.57 Median $120.23 Typical High $147.91 | Professional | 52 · Reduced service | $64.57 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $26.30 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $181.97 Typical High $223.87 | Professional | 54 · Surgery only | $97.72 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $36.31 Typical High $44.67 | Professional | 55 · Aftercare only | $19.50 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $23.99 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.88 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $169.82 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $91.20 | $169.82 | $208.93 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $89.13 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $60.26 | $89.13 | $134.90 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $57.54 Median $57.54 Typical High $77.62 | Professional | Q3 · Living kidney donor | $57.54 | $57.54 | $77.62 |
Where Massachusetts sits
The same service costs 3.5 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· 9th of 51
$302
AK $468TX $135
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.