How much rates vary
Facilitymedian $562 · 10th to 90th $166 to $3,311Professionalmedian $490 · 10th to 90th $182 to $2,291
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 $537.03 Median $2,238.72 Typical High $3,630.78 | Facility | None | $537.03 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $467.74 Typical High $489.78 | Professional | None | $165.96 | $467.74 | $489.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,548.13 | Facility | None | $354.81 | $1,096.48 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $190.55 Median $562.34 Typical High $3,467.37 | Professional | None | $190.55 | $562.34 | $3,467.37 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $363.08 | Facility | None | $158.49 | $190.55 | $363.08 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,288.25 | Professional | None | $457.09 | $457.09 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,202.26 Typical High $1,737.80 | Facility | None | $446.68 | $1,202.26 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $512.86 Typical High $954.99 | Professional | None | $251.19 | $512.86 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $158.49 Median $208.93 Typical High $3,311.31 | Facility | None | $158.49 | $208.93 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $977.24 | Professional | None | $616.60 | $724.44 | $977.24 |
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 $181.97 Median $478.63 Typical High $1,318.26 | Professional | None | $181.97 | $478.63 | $1,318.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,548.13 | Facility | None | $354.81 | $1,096.48 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $190.55 Median $562.34 Typical High $3,467.37 | Professional | None | $190.55 | $562.34 | $3,467.37 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $181.97 Median $457.09 Typical High $1,202.26 | Professional | None | $181.97 | $457.09 | $1,202.26 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $331.13 Typical High $660.69 | Facility | None | $141.25 | $331.13 | $660.69 |
Well Sense Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $338.84 | Professional | None | $125.89 | $186.21 | $338.84 |
7 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 $83.18 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $83.18 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $33.11 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $354.81 Typical High $363.08 | Professional | 54 · Surgery only | $125.89 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $70.79 Typical High $72.44 | Professional | 55 · Aftercare only | $25.12 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $16.60 | $46.77 | $48.98 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $120.23 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $79.43 | $120.23 | $223.87 |
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 4.5 times more in Alaska than in Washington, DC. 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
$490
AK $851DC $191
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.