How much rates vary
Facilitymedian $603 · 10th to 90th $105 to $3,631Professionalmedian $240 · 10th to 90th $91 to $1,047
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 $524.81 Median $2,238.72 Typical High $3,630.78 | Facility | None | $524.81 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $223.87 Typical High $229.09 | Professional | None | $87.10 | $223.87 | $229.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,786.30 | Facility | None | $323.59 | $1,258.93 | $4,786.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $95.50 Median $257.04 Typical High $1,659.59 | Professional | None | $95.50 | $257.04 | $1,659.59 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $134.90 Median $162.18 Typical High $302.00 | Facility | None | $134.90 | $162.18 | $302.00 |
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 $134.90 Median $269.15 Typical High $467.74 | Professional | None | $134.90 | $269.15 | $467.74 |
Fallon Health Setting Facility Modifier None Typical Low $89.13 Median $117.49 Typical High $3,311.31 | Facility | None | $89.13 | $117.49 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $467.74 | Professional | None | $302.00 | $354.81 | $467.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $97.72 Median $245.47 Typical High $630.96 | Professional | None | $97.72 | $245.47 | $630.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,786.30 | Facility | None | $323.59 | $1,258.93 | $4,786.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $95.50 Median $257.04 Typical High $1,659.59 | Professional | None | $95.50 | $257.04 | $1,659.59 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $8,511.38 | Facility | None | $575.44 | $1,380.38 | $8,511.38 |
United Setting Professional Modifier None Typical Low $89.13 Median $213.80 Typical High $588.84 | Professional | None | $89.13 | $213.80 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $74.13 Median $177.83 Typical High $933.25 | Facility | None | $74.13 | $177.83 | $933.25 |
Well Sense Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $165.96 | Professional | None | $60.26 | $89.13 | $165.96 |
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 $43.65 Median $112.20 Typical High $114.82 | Professional | 52 · Reduced service | $43.65 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $44.67 Typical High $45.71 | Professional | 53 · Discontinued | $17.38 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $64.57 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $12.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $22.39 Typical High $22.91 | Professional | 56 · Pre-op care only | $8.71 | $22.39 | $22.91 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $57.54 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $38.02 | $57.54 | $109.65 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | Q3 · Living kidney donor | $53.70 | $53.70 | $72.44 |
Where Massachusetts sits
The same service costs 4.5 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· 8th of 51
$245
AK $437DC $97.72
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.