How much rates vary
Facilitymedian $457 · 10th to 90th $170 to $3,715Professionalmedian $380 · 10th to 90th $195 to $1,514
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $436.52 | Professional | None | $186.21 | $281.84 | $436.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $5,011.87 | Facility | None | $398.11 | $1,318.26 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $204.17 Median $436.52 Typical High $1,949.84 | Professional | None | $204.17 | $436.52 | $1,949.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $173.78 Median $208.93 Typical High $389.05 | Facility | None | $173.78 | $208.93 | $389.05 |
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 $275.42 Median $398.11 Typical High $776.25 | Facility | None | $275.42 | $398.11 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $588.84 | Professional | None | $208.93 | $331.13 | $588.84 |
Fallon Health Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $3,311.31 | Facility | None | $169.82 | $223.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $537.03 | Professional | None | $346.74 | $407.38 | $537.03 |
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 $194.98 Median $389.05 Typical High $741.31 | Professional | None | $194.98 | $389.05 | $741.31 |
Health New England Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $5,011.87 | Facility | None | $398.11 | $1,318.26 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $204.17 Median $436.52 Typical High $1,949.84 | Professional | None | $204.17 | $436.52 | $1,949.84 |
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 $194.98 Median $331.13 Typical High $891.25 | Professional | None | $194.98 | $331.13 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $134.90 Median $199.53 Typical High $309.03 | Facility | None | $134.90 | $199.53 | $309.03 |
Well Sense Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $234.42 | Professional | None | $128.82 | $194.98 | $234.42 |
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 $91.20 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $91.20 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $37.15 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $218.78 Typical High $257.04 | Professional | 54 · Surgery only | $138.04 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $43.65 Typical High $51.29 | Professional | 55 · Aftercare only | $27.54 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $18.62 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $204.17 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $128.82 | $204.17 | $239.88 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $123.03 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $83.18 | $123.03 | $154.88 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | Q3 · Living kidney donor | $102.33 | $102.33 | $138.04 |
Where Massachusetts sits
The same service costs 3.6 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
$380
AK $646TX $178
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.