How much rates vary
Facilitymedian $575 · 10th to 90th $234 to $3,631Professionalmedian $457 · 10th to 90th $245 to $1,698
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $389.05 | Professional | None | $229.09 | $302.00 | $389.05 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $5,011.87 | Facility | None | $446.68 | $1,318.26 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $575.44 Typical High $2,290.87 | Professional | None | $263.03 | $575.44 | $2,290.87 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $524.81 | Facility | None | $229.09 | $275.42 | $524.81 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,659.59 | Professional | None | $602.56 | $602.56 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $1,288.25 | Facility | None | $588.84 | $891.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $724.44 | Professional | None | $288.40 | $398.11 | $724.44 |
Fallon Health Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $3,311.31 | Facility | None | $223.87 | $295.12 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $630.96 | Professional | None | $398.11 | $467.74 | $630.96 |
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 $257.04 Median $512.86 Typical High $870.96 | Professional | None | $257.04 | $512.86 | $870.96 |
Health New England Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Health New England Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $5,011.87 | Facility | None | $446.68 | $1,318.26 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $575.44 Typical High $2,290.87 | Professional | None | $263.03 | $575.44 | $2,290.87 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,165.95 | Facility | None | $575.44 | $1,380.38 | $6,165.95 |
United Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $1,071.52 | Professional | None | $257.04 | $416.87 | $1,071.52 |
Well Sense Setting Facility Modifier None Typical Low $204.17 Median $323.59 Typical High $512.86 | Facility | None | $204.17 | $323.59 | $512.86 |
Well Sense Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $263.03 | Professional | None | $165.96 | $218.78 | $263.03 |
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 $112.20 Median $151.36 Typical High $190.55 | Professional | 52 · Reduced service | $112.20 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $61.66 Typical High $75.86 | Professional | 53 · Discontinued | $45.71 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $229.09 Typical High $288.40 | Professional | 54 · Surgery only | $169.82 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $33.88 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $38.02 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $213.80 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $158.49 | $213.80 | $269.15 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $141.25 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $107.15 | $141.25 | $177.83 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | Q3 · Living kidney donor | $128.82 | $128.82 | $173.78 |
Where Massachusetts sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$457
AK $933UT $219
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.