How much rates vary
Facilitymedian $229 · 10th to 90th $58 to $2,570Professionalmedian $145 · 10th to 90th $54 to $708
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 $316.23 Median $2,238.72 Typical High $3,630.78 | Facility | None | $316.23 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $125.89 Typical High $144.54 | Professional | None | $53.70 | $125.89 | $144.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $112.20 Median $724.44 Typical High $2,454.71 | Facility | None | $112.20 | $724.44 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $53.70 Median $173.78 Typical High $1,096.48 | Professional | None | $53.70 | $173.78 | $1,096.48 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $81.28 Median $97.72 Typical High $186.21 | Facility | None | $81.28 | $97.72 | $186.21 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $331.13 | Professional | None | $81.28 | $177.83 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $223.87 Typical High $489.78 | Facility | None | $100.00 | $223.87 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $169.82 Typical High $309.03 | Professional | None | $77.62 | $169.82 | $309.03 |
Fallon Health Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $3,311.31 | Facility | None | $50.12 | $66.07 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $309.03 | Professional | None | $199.53 | $234.42 | $309.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $54.95 Median $144.54 Typical High $416.87 | Professional | None | $54.95 | $144.54 | $416.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $112.20 Median $724.44 Typical High $2,454.71 | Facility | None | $112.20 | $724.44 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $53.70 Median $173.78 Typical High $1,096.48 | Professional | None | $53.70 | $173.78 | $1,096.48 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $50.12 Median $131.83 Typical High $371.54 | Professional | None | $50.12 | $131.83 | $371.54 |
Well Sense Setting Facility Modifier None Typical Low $42.66 Median $79.43 Typical High $151.36 | Facility | None | $42.66 | $79.43 | $151.36 |
Well Sense Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $100.00 | Professional | None | $37.15 | $54.95 | $100.00 |
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 $26.92 Median $64.57 Typical High $69.18 | Professional | 52 · Reduced service | $26.92 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $25.70 Typical High $27.54 | Professional | 53 · Discontinued | $10.72 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $97.72 Typical High $102.33 | Professional | 54 · Surgery only | $39.81 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $19.50 Typical High $20.89 | Professional | 55 · Aftercare only | $8.13 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $12.88 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.37 | $12.88 | $13.80 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $87.10 Typical High $165.96 | Professional | 52 · Reduced service | $40.74 | $87.10 | $165.96 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $112.20 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $64.57 | $112.20 | $147.91 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $23.44 Median $35.48 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $23.44 | $35.48 | $66.07 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | Q3 · Living kidney donor | $38.02 | $38.02 | $51.29 |
Where Massachusetts sits
The same service costs 3.5 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· 11th of 51
$145
AK $224DC $63.10
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.