How much rates vary
Facilitymedian $1,820 · 10th to 90th $813 to $5,888Professionalmedian $1,660 · 10th to 90th $912 to $9,333
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 $2,691.53 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,691.53 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,348.96 | Professional | None | $891.25 | $891.25 | $1,348.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $2,344.23 Typical High $5,888.44 | Facility | None | $724.44 | $2,344.23 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $9,332.54 | Professional | None | $1,047.13 | $2,454.71 | $9,332.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,659.59 | Professional | None | $977.24 | $977.24 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,949.84 Typical High $2,884.03 | Facility | None | $954.99 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,230.27 | $2,344.23 |
Fallon Health Setting Facility Modifier None Typical Low $933.25 Median $1,230.27 Typical High $3,311.31 | Facility | None | $933.25 | $1,230.27 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,258.93 | $1,698.24 |
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 $1,047.13 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,949.84 | $2,884.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $2,344.23 Typical High $5,888.44 | Facility | None | $724.44 | $2,344.23 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $9,332.54 | Professional | None | $1,047.13 | $2,454.71 | $9,332.54 |
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 $1,023.29 Median $1,380.38 Typical High $4,073.80 | Professional | None | $1,023.29 | $1,380.38 | $4,073.80 |
Well Sense Setting Facility Modifier None Typical Low $794.33 Median $977.24 Typical High $1,445.44 | Facility | None | $794.33 | $977.24 | $1,445.44 |
Well Sense Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $912.01 | Professional | None | $676.08 | $676.08 | $912.01 |
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 $436.52 Median $436.52 Typical High $676.08 | Professional | 52 · Reduced service | $436.52 | $436.52 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $269.15 | Professional | 53 · Discontinued | $177.83 | $177.83 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $1,023.29 | Professional | 54 · Surgery only | $660.69 | $660.69 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $204.17 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $134.90 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $954.99 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $575.44 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | Q3 · Living kidney donor | $489.78 | $489.78 | $660.69 |
Where Massachusetts sits
The same service costs 6.2 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· 12th of 51
$1,660
AK $3,802TX $617
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.