How much rates vary
Facilitymedian $380 · 10th to 90th $145 to $3,631Professionalmedian $331 · 10th to 90th $166 to $1,349
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 $151.36 Median $245.47 Typical High $346.74 | Professional | None | $151.36 | $245.47 | $346.74 |
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 $181.97 Median $380.19 Typical High $1,737.80 | Professional | None | $181.97 | $380.19 | $1,737.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $147.91 Median $177.83 Typical High $338.84 | Facility | None | $147.91 | $177.83 | $338.84 |
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 $309.03 Typical High $489.78 | Facility | None | $199.53 | $309.03 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $537.03 | Professional | None | $181.97 | $295.12 | $537.03 |
Fallon Health Setting Facility Modifier None Typical Low $144.54 Median $190.55 Typical High $3,311.31 | Facility | None | $144.54 | $190.55 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $478.63 | Professional | None | $302.00 | $363.08 | $478.63 |
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 $165.96 Median $338.84 Typical High $660.69 | Professional | None | $165.96 | $338.84 | $660.69 |
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 $181.97 Median $380.19 Typical High $1,737.80 | Professional | None | $181.97 | $380.19 | $1,737.80 |
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 $165.96 Median $316.23 Typical High $812.83 | Professional | None | $165.96 | $316.23 | $812.83 |
Well Sense Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $275.42 | Facility | None | $125.89 | $181.97 | $275.42 |
Well Sense Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $208.93 | Professional | None | $112.20 | $165.96 | $208.93 |
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 $75.86 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $75.86 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $30.20 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $181.97 Typical High $223.87 | Professional | 54 · Surgery only | $112.20 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $22.91 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $15.14 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $169.82 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $104.71 | $169.82 | $208.93 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $107.15 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $70.79 | $107.15 | $141.25 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $91.20 Median $91.20 Typical High $123.03 | Professional | Q3 · Living kidney donor | $91.20 | $91.20 | $123.03 |
Where Massachusetts sits
The same service costs 3.5 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
$331
AK $575NJ $166
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.