How much rates vary
Facilitymedian $708 · 10th to 90th $282 to $3,715Professionalmedian $562 · 10th to 90th $295 to $2,089
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 $794.33 Median $2,691.53 Typical High $3,715.35 | Facility | None | $794.33 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $794.33 | Professional | None | $288.40 | $380.19 | $794.33 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $5,011.87 | Facility | None | $446.68 | $1,318.26 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $2,754.23 | Professional | None | $309.03 | $691.83 | $2,754.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $281.84 Median $338.84 Typical High $645.65 | Facility | None | $281.84 | $338.84 | $645.65 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,659.59 | Professional | None | $602.56 | $602.56 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $2,818.38 | Facility | None | $588.84 | $1,949.84 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $851.14 | Professional | None | $346.74 | $478.63 | $851.14 |
Fallon Health Setting Facility Modifier None Typical Low $275.42 Median $363.08 Typical High $3,311.31 | Facility | None | $275.42 | $363.08 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $758.58 | Professional | None | $478.63 | $562.34 | $758.58 |
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 $309.03 Median $616.60 Typical High $1,047.13 | Professional | None | $309.03 | $616.60 | $1,047.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $5,011.87 | Facility | None | $446.68 | $1,318.26 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $2,754.23 | Professional | None | $309.03 | $691.83 | $2,754.23 |
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 $309.03 Median $489.78 Typical High $1,288.25 | Professional | None | $309.03 | $489.78 | $1,288.25 |
Well Sense Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $891.25 | Facility | None | $245.47 | $389.05 | $891.25 |
Well Sense Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $316.23 | Professional | None | $204.17 | $263.03 | $316.23 |
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 $144.54 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $144.54 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $77.62 Typical High $91.20 | Professional | 53 · Discontinued | $57.54 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $288.40 Typical High $346.74 | Professional | 54 · Surgery only | $218.78 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $57.54 Typical High $69.18 | Professional | 55 · Aftercare only | $43.65 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $28.84 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $269.15 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $204.17 | $269.15 | $323.59 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $169.82 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $128.82 | $169.82 | $208.93 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | Q3 · Living kidney donor | $141.25 | $141.25 | $190.55 |
Where Massachusetts sits
The same service costs 4.1 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· 9th of 51
$562
AK $1,072NJ $263
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.