How much rates vary
Facilitymedian $1,950 · 10th to 90th $724 to $6,918Professionalmedian $1,318 · 10th to 90th $759 to $6,918
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 $2,570.40 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,570.40 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $954.99 | Professional | None | $758.58 | $758.58 | $954.99 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $9,549.93 | Facility | None | $724.44 | $3,090.30 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $776.25 Median $2,041.74 Typical High $6,918.31 | Professional | None | $776.25 | $2,041.74 | $6,918.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $3,311.31 | Professional | None | $977.24 | $1,380.38 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,890.45 Typical High $5,754.40 | Facility | None | $954.99 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,862.09 | Professional | None | $977.24 | $977.24 | $1,862.09 |
Fallon Health Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $3,311.31 | Facility | None | $776.25 | $1,000.00 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $891.25 | $1,047.13 | $1,412.54 |
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 $831.76 Median $1,548.82 Typical High $2,290.87 | Professional | None | $831.76 | $1,548.82 | $2,290.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $9,549.93 | Facility | None | $724.44 | $3,090.30 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $776.25 Median $2,041.74 Typical High $6,918.31 | Professional | None | $776.25 | $2,041.74 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $13,489.63 | Facility | None | $1,071.52 | $3,467.37 | $13,489.63 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $3,019.95 | Professional | None | $776.25 | $1,096.48 | $3,019.95 |
Well Sense Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,905.46 | Facility | None | $630.96 | $851.14 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $741.31 | Professional | None | $549.54 | $549.54 | $741.31 |
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 $380.19 Median $380.19 Typical High $524.81 | Professional | 52 · Reduced service | $380.19 | $380.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $213.80 | Professional | 53 · Discontinued | $151.36 | $151.36 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $794.33 | Professional | 54 · Surgery only | $562.34 | $562.34 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $158.49 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $741.31 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $467.74 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $288.40 Median $288.40 Typical High $389.05 | Professional | Q3 · Living kidney donor | $288.40 | $288.40 | $389.05 |
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
$1,349
AK $3,020TX $490
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.