How much rates vary
Facilitymedian $2,818 · 10th to 90th $407 to $4,467Professionalmedian $4,898 · 10th to 90th $2,630 to $19,498
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 $3,090.30 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,570.40 | $2,570.40 | $3,890.45 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,918.31 | Facility | None | $346.74 | $1,047.13 | $6,918.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,019.95 Median $7,585.78 Typical High $19,498.45 | Professional | None | $3,019.95 | $7,585.78 | $19,498.45 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $2,951.21 Median $4,897.79 Typical High $6,760.83 | Professional | None | $2,951.21 | $4,897.79 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $4,570.88 Typical High $6,918.31 | Professional | None | $3,715.35 | $4,570.88 | $6,918.31 |
Fallon Health Setting Facility Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $4,466.84 | Facility | None | $2,884.03 | $3,630.78 | $4,466.84 |
Fallon Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $5,128.61 | Professional | None | $3,311.31 | $3,890.45 | $5,128.61 |
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 $3,162.28 Median $6,165.95 Typical High $8,511.38 | Professional | None | $3,162.28 | $6,165.95 | $8,511.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,918.31 | Facility | None | $346.74 | $1,047.13 | $6,918.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,019.95 Median $7,585.78 Typical High $19,498.45 | Professional | None | $3,019.95 | $7,585.78 | $19,498.45 |
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 $2,818.38 Median $3,801.89 Typical High $12,022.64 | Professional | None | $2,818.38 | $3,801.89 | $12,022.64 |
Well Sense Setting Facility Modifier None Typical Low $2,137.96 Median $2,951.21 Typical High $4,365.16 | Facility | None | $2,137.96 | $2,951.21 | $4,365.16 |
Well Sense Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,949.84 | $1,949.84 | $2,691.53 |
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 $1,288.25 Median $1,288.25 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $776.25 | Professional | 53 · Discontinued | $512.86 | $512.86 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $389.05 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $2,691.53 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $3,162.28 Typical High $4,265.80 | Professional | 62 · Two surgeons | $1,862.09 | $3,162.28 | $4,265.80 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $1,445.44 Median $1,445.44 Typical High $1,949.84 | Professional | Q3 · Living kidney donor | $1,445.44 | $1,445.44 | $1,949.84 |
Where Massachusetts sits
The same service costs 21.4 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· 14th of 51
$4,571
AK $9,772TX $457
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.