How much rates vary
Facilitymedian $1,072 · 10th to 90th $263 to $5,495Professionalmedian $501 · 10th to 90th $275 to $1,820
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 $758.58 Median $2,691.53 Typical High $3,715.35 | Facility | None | $758.58 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $467.74 | Professional | None | $257.04 | $323.59 | $467.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $2,041.74 Typical High $6,918.31 | Facility | None | $457.09 | $2,041.74 | $6,918.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $295.12 Median $645.65 Typical High $2,454.71 | Professional | None | $295.12 | $645.65 | $2,454.71 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $588.84 | Facility | None | $257.04 | $309.03 | $588.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $3,311.31 | Professional | None | $602.56 | $602.56 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,890.45 Typical High $5,754.40 | Facility | None | $588.84 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $831.76 | Professional | None | $331.13 | $426.58 | $831.76 |
Fallon Health Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $3,311.31 | Facility | None | $257.04 | $331.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $660.69 | Professional | None | $426.58 | $501.19 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $288.40 Median $575.44 Typical High $933.25 | Professional | None | $288.40 | $575.44 | $933.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $2,041.74 Typical High $6,918.31 | Facility | None | $457.09 | $2,041.74 | $6,918.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $295.12 Median $645.65 Typical High $2,454.71 | Professional | None | $295.12 | $645.65 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $11,481.54 | Facility | None | $1,047.13 | $2,344.23 | $11,481.54 |
United Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $1,230.27 | Professional | None | $288.40 | $446.68 | $1,230.27 |
Well Sense Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $1,905.46 | Facility | None | $234.42 | $354.81 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $281.84 | Professional | None | $190.55 | $234.42 | $281.84 |
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 $128.82 Median $162.18 Typical High $204.17 | Professional | 52 · Reduced service | $128.82 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $64.57 Typical High $83.18 | Professional | 53 · Discontinued | $51.29 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $245.47 Typical High $309.03 | Professional | 54 · Surgery only | $190.55 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $48.98 Typical High $61.66 | Professional | 55 · Aftercare only | $38.02 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $32.36 Typical High $41.69 | Professional | 56 · Pre-op care only | $25.70 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $229.09 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $177.83 | $229.09 | $288.40 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $151.36 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $123.03 | $151.36 | $190.55 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | Q3 · Living kidney donor | $147.91 | $147.91 | $199.53 |
Where Massachusetts sits
The same service costs 8.7 times more in Alaska than in North Dakota. 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.
Physician feeFacility fee
AK $7,504ND $861
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.