How much rates vary
Facilitymedian $372 · 10th to 90th $138 to $3,631Professionalmedian $309 · 10th to 90th $145 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 $134.90 Median $223.87 Typical High $380.19 | Professional | None | $134.90 | $223.87 | $380.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,786.30 | Facility | None | $323.59 | $1,258.93 | $4,786.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $154.88 Median $363.08 Typical High $1,698.24 | Professional | None | $154.88 | $363.08 | $1,698.24 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $316.23 | Facility | None | $138.04 | $165.96 | $316.23 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,621.81 | $1,621.81 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $489.78 | Facility | None | $199.53 | $316.23 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $537.03 | Professional | None | $169.82 | $302.00 | $537.03 |
Fallon Health Setting Facility Modifier None Typical Low $134.90 Median $177.83 Typical High $3,311.31 | Facility | None | $134.90 | $177.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $467.74 | Professional | None | $302.00 | $354.81 | $467.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $151.36 Median $309.03 Typical High $660.69 | Professional | None | $151.36 | $309.03 | $660.69 |
Health New England Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,786.30 | Facility | None | $323.59 | $1,258.93 | $4,786.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $154.88 Median $363.08 Typical High $1,698.24 | Professional | None | $154.88 | $363.08 | $1,698.24 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $8,709.64 | Facility | None | $575.44 | $1,380.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $724.44 | Professional | None | $151.36 | $269.15 | $724.44 |
Well Sense Setting Facility Modifier None Typical Low $112.20 Median $173.78 Typical High $275.42 | Facility | None | $112.20 | $173.78 | $275.42 |
Well Sense Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $186.21 | Professional | None | $95.50 | $144.54 | $186.21 |
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 $67.61 Median $112.20 Typical High $141.25 | Professional | 52 · Reduced service | $67.61 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $44.67 Typical High $56.23 | Professional | 53 · Discontinued | $26.92 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $169.82 Typical High $213.80 | Professional | 54 · Surgery only | $102.33 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $20.42 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $22.39 Typical High $28.18 | Professional | 56 · Pre-op care only | $13.49 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $158.49 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $95.50 | $158.49 | $199.53 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $93.33 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $61.66 | $93.33 | $123.03 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | Q3 · Living kidney donor | $81.28 | $81.28 | $109.65 |
Where Massachusetts sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$309
AK $525DC $158
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.