How much rates vary
Facilitymedian $3,388 · 10th to 90th $407 to $6,607Professionalmedian $7,413 · 10th to 90th $4,365 to $30,200
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 $2,691.53 Median $3,388.44 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,388.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $5,888.44 | Professional | None | $4,570.88 | $4,570.88 | $5,888.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $10,000.00 | Facility | None | $346.74 | $1,047.13 | $10,000.00 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,981.07 Median $11,481.54 Typical High $30,199.52 | Professional | None | $3,981.07 | $11,481.54 | $30,199.52 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $6,918.31 Typical High $10,471.29 | Professional | None | $5,495.41 | $6,918.31 | $10,471.29 |
Fallon Health Setting Facility Modifier None Typical Low $3,311.31 Median $5,623.41 Typical High $6,606.93 | Facility | None | $3,311.31 | $5,623.41 | $6,606.93 |
Fallon Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,888.44 Typical High $7,943.28 | Professional | None | $5,011.87 | $5,888.44 | $7,943.28 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $5,011.87 Median $9,549.93 Typical High $13,182.57 | Professional | None | $5,011.87 | $9,549.93 | $13,182.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $10,000.00 | Facility | None | $346.74 | $1,047.13 | $10,000.00 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,981.07 Median $11,481.54 Typical High $30,199.52 | Professional | None | $3,981.07 | $11,481.54 | $30,199.52 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $6,025.60 Typical High $16,982.44 | Professional | None | $3,019.95 | $6,025.60 | $16,982.44 |
Well Sense Setting Facility Modifier None Typical Low $3,235.94 Median $4,466.84 Typical High $6,606.93 | Facility | None | $3,235.94 | $4,466.84 | $6,606.93 |
Well Sense Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Professional | None | $3,235.94 | $3,235.94 | $4,365.16 |
9 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 $2,238.72 Median $2,238.72 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,238.72 | $2,238.72 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $912.01 Typical High $1,174.90 | Professional | 53 · Discontinued | $912.01 | $912.01 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,388.44 Typical High $4,466.84 | Professional | 54 · Surgery only | $3,388.44 | $3,388.44 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $676.08 Typical High $891.25 | Professional | 55 · Aftercare only | $676.08 | $676.08 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $457.09 Typical High $588.84 | Professional | 56 · Pre-op care only | $457.09 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,162.28 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,162.28 | $4,168.69 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $2,818.38 Median $4,897.79 Typical High $6,456.54 | Professional | 62 · Two surgeons | $2,818.38 | $4,897.79 | $6,456.54 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,818.38 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $1,122.02 Median $1,122.02 Typical High $1,513.56 | Professional | Q3 · Living kidney donor | $1,122.02 | $1,122.02 | $1,513.56 |
Where Massachusetts sits
The same service costs 21.9 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· 13th of 51
$7,079
AK $15,136TX $692
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.