How much rates vary
Facilitymedian $1,259 · 10th to 90th $437 to $5,012Professionalmedian $661 · 10th to 90th $363 to $4,169
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $549.54 | Professional | None | $363.08 | $363.08 | $549.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,819.70 Typical High $5,128.61 | Facility | None | $457.09 | $1,819.70 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $380.19 Median $1,023.29 Typical High $4,168.69 | Professional | None | $380.19 | $1,023.29 | $4,168.69 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,737.80 | Professional | None | $602.56 | $602.56 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,905.46 Typical High $2,754.23 | Facility | None | $588.84 | $1,905.46 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $912.01 | Professional | None | $489.78 | $616.60 | $912.01 |
Fallon Health Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $3,311.31 | Facility | None | $416.87 | $537.03 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $741.31 | Professional | None | $467.74 | $549.54 | $741.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $426.58 Median $851.14 Typical High $1,174.90 | Professional | None | $426.58 | $851.14 | $1,174.90 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,819.70 Typical High $5,128.61 | Facility | None | $457.09 | $1,819.70 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $380.19 Median $1,023.29 Typical High $4,168.69 | Professional | None | $380.19 | $1,023.29 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $1,584.89 | Professional | None | $380.19 | $512.86 | $1,584.89 |
Well Sense Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $933.25 | Facility | None | $302.00 | $489.78 | $933.25 |
Well Sense Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $338.84 | Professional | None | $251.19 | $251.19 | $338.84 |
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 $181.97 Median $181.97 Typical High $257.04 | Professional | 52 · Reduced service | $181.97 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $102.33 | Professional | 53 · Discontinued | $72.44 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $389.05 | Professional | 54 · Surgery only | $269.15 | $269.15 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $77.62 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $51.29 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $363.08 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $218.78 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $208.93 Median $208.93 Typical High $281.84 | Professional | Q3 · Living kidney donor | $208.93 | $208.93 | $281.84 |
Where Massachusetts sits
The same service costs 5.1 times more in Alaska 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· 11th of 51
$708
AK $1,549UT $302
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.