How much rates vary
Facilitymedian $933 · 10th to 90th $123 to $4,074Professionalmedian $269 · 10th to 90th $107 to $1,072
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 $100.00 Median $229.09 Typical High $263.03 | Professional | None | $100.00 | $229.09 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,698.24 Typical High $5,011.87 | Facility | None | $323.59 | $1,698.24 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $109.65 Median $288.40 Typical High $1,737.80 | Professional | None | $109.65 | $288.40 | $1,737.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $147.91 Median $177.83 Typical High $338.84 | Facility | None | $147.91 | $177.83 | $338.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,737.80 | Professional | None | $630.96 | $630.96 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,819.70 Typical High $2,754.23 | Facility | None | $446.68 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $478.63 | Professional | None | $158.49 | $269.15 | $478.63 |
Fallon Health Setting Facility Modifier None Typical Low $104.71 Median $138.04 Typical High $3,311.31 | Facility | None | $104.71 | $138.04 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $489.78 | Professional | None | $309.03 | $363.08 | $489.78 |
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 $114.82 Median $269.15 Typical High $660.69 | Professional | None | $114.82 | $269.15 | $660.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,698.24 Typical High $5,011.87 | Facility | None | $323.59 | $1,698.24 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $109.65 Median $288.40 Typical High $1,737.80 | Professional | None | $109.65 | $288.40 | $1,737.80 |
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 $102.33 Median $239.88 Typical High $602.56 | Professional | None | $102.33 | $239.88 | $602.56 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $181.97 Typical High $933.25 | Facility | None | $87.10 | $181.97 | $933.25 |
Well Sense Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $177.83 | Professional | None | $70.79 | $104.71 | $177.83 |
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 $50.12 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $50.12 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $19.95 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $75.86 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $34.67 Typical High $39.81 | Professional | 55 · Aftercare only | $15.14 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $10.00 | $22.91 | $26.30 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $67.61 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $45.71 | $67.61 | $120.23 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | Q3 · Living kidney donor | $79.43 | $79.43 | $107.15 |
Where Massachusetts sits
The same service costs 4.0 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
$269
AK $468DC $117
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.