How much rates vary
Facilitymedian $2,570 · 10th to 90th $759 to $7,413Professionalmedian $1,318 · 10th to 90th $741 to $8,710
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 $2,570.40 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,570.40 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,047.13 | Professional | None | $741.31 | $741.31 | $1,047.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $9,772.37 | Facility | None | $724.44 | $3,467.37 | $9,772.37 |
AllWays Health Partners Setting Professional Modifier None Typical Low $812.83 Median $2,041.74 Typical High $8,709.64 | Professional | None | $812.83 | $2,041.74 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,890.45 Typical High $5,754.40 | Facility | None | $954.99 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,230.27 | $1,819.70 |
Fallon Health Setting Facility Modifier None Typical Low $776.25 Median $1,023.29 Typical High $3,311.31 | Facility | None | $776.25 | $1,023.29 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $891.25 | $1,047.13 | $1,412.54 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,344.23 | Professional | None | $891.25 | $1,659.59 | $2,344.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $9,772.37 | Facility | None | $724.44 | $3,467.37 | $9,772.37 |
Mass General Brigham Setting Professional Modifier None Typical Low $812.83 Median $2,041.74 Typical High $8,709.64 | Professional | None | $812.83 | $2,041.74 | $8,709.64 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $15,488.17 | Facility | None | $1,071.52 | $3,890.45 | $15,488.17 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $3,162.28 | Professional | None | $812.83 | $1,047.13 | $3,162.28 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $1,174.90 | Facility | None | $562.34 | $758.58 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | None | $524.81 | $524.81 | $707.95 |
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 $371.54 Median $371.54 Typical High $524.81 | Professional | 52 · Reduced service | $371.54 | $371.54 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | 53 · Discontinued | $147.91 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $776.25 | Professional | 54 · Surgery only | $549.54 | $549.54 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $154.88 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $724.44 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $223.87 Typical High $295.12 | Professional | 80 · Assistant surgeon | $128.82 | $223.87 | $295.12 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $457.09 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | Q3 · Living kidney donor | $371.54 | $371.54 | $501.19 |
Where Massachusetts sits
The same service costs 25.1 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· 11th of 51
$1,380
AK $3,090TX $123
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.