How much rates vary
Facilitymedian $741 · 10th to 90th $309 to $5,370Professionalmedian $708 · 10th to 90th $339 to $2,570
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 $398.11 Median $2,691.53 Typical High $5,128.61 | Facility | None | $398.11 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $575.44 | Professional | None | $269.15 | $398.11 | $575.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $478.63 Median $2,290.87 Typical High $5,888.44 | Facility | None | $478.63 | $2,290.87 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $346.74 Median $851.14 Typical High $3,801.89 | Professional | None | $346.74 | $851.14 | $3,801.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $346.74 Median $426.58 Typical High $794.33 | Facility | None | $346.74 | $426.58 | $794.33 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $1,659.59 | Professional | None | $446.68 | $794.33 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $707.95 Typical High $912.01 | Facility | None | $100.00 | $707.95 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $1,096.48 | Professional | None | $407.38 | $630.96 | $1,096.48 |
Fallon Health Setting Facility Modifier None Typical Low $338.84 Median $446.68 Typical High $3,311.31 | Facility | None | $338.84 | $446.68 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,071.52 | Professional | None | $676.08 | $794.33 | $1,071.52 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $758.58 Typical High $1,445.44 | Professional | None | $363.08 | $758.58 | $1,445.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $478.63 Median $2,290.87 Typical High $5,888.44 | Facility | None | $478.63 | $2,290.87 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $346.74 Median $851.14 Typical High $3,801.89 | Professional | None | $346.74 | $851.14 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $10,964.78 | Facility | None | $1,071.52 | $3,467.37 | $10,964.78 |
United Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $1,698.24 | Professional | None | $338.84 | $549.54 | $1,698.24 |
Well Sense Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $562.34 | Facility | None | $257.04 | $371.54 | $562.34 |
Well Sense Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $323.59 | Professional | None | $194.98 | $269.15 | $323.59 |
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 $134.90 Median $194.98 Typical High $288.40 | Professional | 52 · Reduced service | $134.90 | $194.98 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $79.43 Typical High $114.82 | Professional | 53 · Discontinued | $53.70 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $295.12 Typical High $426.58 | Professional | 54 · Surgery only | $204.17 | $295.12 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $58.88 Typical High $85.11 | Professional | 55 · Aftercare only | $40.74 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $39.81 Typical High $57.54 | Professional | 56 · Pre-op care only | $26.92 | $39.81 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $275.42 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $190.55 | $275.42 | $398.11 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $123.03 | $169.82 | $213.80 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | Q3 · Living kidney donor | $134.90 | $134.90 | $181.97 |
Where Massachusetts sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 8th of 51
$708
AK $1,259KY $295
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.