How much rates vary
Facilitymedian $501 · 10th to 90th $87 to $2,570Professionalmedian $692 · 10th to 90th $417 to $2,692
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 $1,096.48 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,096.48 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $602.56 | Professional | None | $416.87 | $416.87 | $602.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $416.87 Typical High $1,862.09 | Facility | None | $87.10 | $416.87 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $426.58 Median $1,047.13 Typical High $2,691.53 | Professional | None | $426.58 | $1,047.13 | $2,691.53 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $446.68 | Professional | None | $151.36 | $151.36 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $173.78 Typical High $251.19 | Facility | None | $53.70 | $173.78 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,000.00 | Professional | None | $524.81 | $524.81 | $1,000.00 |
Fallon Health Setting Facility Modifier None Typical Low $407.38 Median $524.81 Typical High $3,311.31 | Facility | None | $407.38 | $524.81 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $724.44 | Professional | None | $457.09 | $537.03 | $724.44 |
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 $436.52 Median $831.76 Typical High $1,202.26 | Professional | None | $436.52 | $831.76 | $1,202.26 |
Health New England Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $416.87 Typical High $1,862.09 | Facility | None | $87.10 | $416.87 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $426.58 Median $1,047.13 Typical High $2,691.53 | Professional | None | $426.58 | $1,047.13 | $2,691.53 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $1,659.59 | Professional | None | $426.58 | $562.34 | $1,659.59 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $346.74 Typical High $616.60 | Facility | None | $87.10 | $346.74 | $616.60 |
Well Sense Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Professional | None | $288.40 | $288.40 | $389.05 |
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 $208.93 Median $208.93 Typical High $288.40 | Professional | 52 · Reduced service | $208.93 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $114.82 | Professional | 53 · Discontinued | $83.18 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | 54 · Surgery only | $309.03 | $309.03 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $398.11 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $245.47 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | Q3 · Living kidney donor | $173.78 | $173.78 | $234.42 |
Where Massachusetts sits
The same service costs 4.2 times more in Wyoming 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· 14th of 51
$646
WY $1,288UT $309
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.