How much rates vary
Facilitymedian $1,259 · 10th to 90th $245 to $5,129Professionalmedian $355 · 10th to 90th $209 to $1,585
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 $602.56 Median $2,818.38 Typical High $5,248.07 | Facility | None | $602.56 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $501.19 | Professional | None | $208.93 | $208.93 | $501.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $5,128.61 | Facility | None | $602.56 | $1,819.70 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $239.88 Median $575.44 Typical High $1,584.89 | Professional | None | $239.88 | $575.44 | $1,584.89 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,659.59 | Professional | None | $776.25 | $776.25 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,949.84 Typical High $2,884.03 | Facility | None | $676.08 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $549.54 | Professional | None | $281.84 | $281.84 | $549.54 |
Fallon Health Setting Facility Modifier None Typical Low $218.78 Median $295.12 Typical High $3,311.31 | Facility | None | $218.78 | $295.12 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $389.05 | Professional | None | $245.47 | $295.12 | $389.05 |
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 $234.42 Median $446.68 Typical High $645.65 | Professional | None | $234.42 | $446.68 | $645.65 |
Health New England Setting Facility Modifier None Typical Low $891.25 Median $5,011.87 Typical High $7,079.46 | Facility | None | $891.25 | $5,011.87 | $7,079.46 |
Health New England Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $5,128.61 | Facility | None | $602.56 | $1,819.70 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $239.88 Median $575.44 Typical High $1,584.89 | Professional | None | $239.88 | $575.44 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $891.25 | Professional | None | $223.87 | $302.00 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $177.83 Median $323.59 Typical High $891.25 | Facility | None | $177.83 | $323.59 | $891.25 |
Well Sense Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
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 $104.71 Median $104.71 Typical High $147.91 | Professional | 52 · Reduced service | $104.71 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $58.88 | Professional | 53 · Discontinued | $41.69 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | 54 · Surgery only | $158.49 | $158.49 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $204.17 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $97.72 | $97.72 | $131.83 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | Q3 · Living kidney donor | $107.15 | $107.15 | $144.54 |
Where Massachusetts sits
The same service costs 5.6 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
$389
AK $871UT $155
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.