How much rates vary
Facilitymedian $331 · 10th to 90th $178 to $2,239Professionalmedian $380 · 10th to 90th $195 to $1,445
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 $177.83 Median $257.04 Typical High $323.59 | Professional | None | $177.83 | $257.04 | $323.59 |
AllWays Health Partners Setting Facility Modifier None Typical Low $190.55 Median $501.19 Typical High $1,862.09 | Facility | None | $190.55 | $501.19 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $204.17 Median $457.09 Typical High $2,398.83 | Professional | None | $204.17 | $457.09 | $2,398.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $416.87 | Facility | None | $186.21 | $223.87 | $416.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $363.08 | Professional | None | $204.17 | $204.17 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $489.78 Typical High $630.96 | Facility | None | $446.68 | $489.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $602.56 | Professional | None | $234.42 | $338.84 | $602.56 |
Fallon Health Setting Facility Modifier None Typical Low $181.97 Median $239.88 Typical High $3,311.31 | Facility | None | $181.97 | $239.88 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $537.03 | Professional | None | $338.84 | $398.11 | $537.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $199.53 Median $416.87 Typical High $741.31 | Professional | None | $199.53 | $416.87 | $741.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $190.55 Median $501.19 Typical High $1,862.09 | Facility | None | $190.55 | $501.19 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $204.17 Median $457.09 Typical High $2,398.83 | Professional | None | $204.17 | $457.09 | $2,398.83 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $933.25 | Professional | None | $199.53 | $331.13 | $933.25 |
Well Sense Setting Facility Modifier None Typical Low $151.36 Median $208.93 Typical High $331.13 | Facility | None | $151.36 | $208.93 | $331.13 |
Well Sense Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $218.78 | Professional | None | $128.82 | $181.97 | $218.78 |
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 $89.13 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $89.13 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $51.29 Typical High $64.57 | Professional | 53 · Discontinued | $35.48 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $131.83 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $26.92 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.70 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.78 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $181.97 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $123.03 | $181.97 | $223.87 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $117.49 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $83.18 | $117.49 | $144.54 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | Q3 · Living kidney donor | $104.71 | $104.71 | $141.25 |
Where Massachusetts sits
The same service costs 4.2 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· 10th of 51
$380
AK $741TX $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.