How much rates vary
Facilitymedian $1,259 · 10th to 90th $282 to $5,012Professionalmedian $437 · 10th to 90th $245 to $1,660
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 $1,230.27 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,230.27 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $371.54 | Professional | None | $245.47 | $245.47 | $371.54 |
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 $275.42 Median $645.65 Typical High $1,659.59 | Professional | None | $275.42 | $645.65 | $1,659.59 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,659.59 | Professional | None | $851.14 | $851.14 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,949.84 Typical High $2,884.03 | Facility | None | $831.76 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $616.60 | Professional | None | $323.59 | $323.59 | $616.60 |
Fallon Health Setting Facility Modifier None Typical Low $251.19 Median $331.13 Typical High $3,311.31 | Facility | None | $251.19 | $331.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $446.68 | Professional | None | $281.84 | $331.13 | $446.68 |
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 $269.15 Median $501.19 Typical High $741.31 | Professional | None | $269.15 | $501.19 | $741.31 |
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 $275.42 Median $645.65 Typical High $1,659.59 | Professional | None | $275.42 | $645.65 | $1,659.59 |
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 $257.04 Median $354.81 Typical High $1,000.00 | Professional | None | $257.04 | $354.81 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $891.25 | Facility | None | $204.17 | $331.13 | $891.25 |
Well Sense Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $239.88 | Professional | None | $177.83 | $177.83 | $239.88 |
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 $120.23 Median $120.23 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $48.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $251.19 | Professional | 54 · Surgery only | $181.97 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $234.42 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $154.88 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | Q3 · Living kidney donor | $147.91 | $147.91 | $199.53 |
Where Massachusetts sits
The same service costs 6.0 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· 9th of 51
$447
AK $1,000UT $166
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.