How much rates vary
Facilitymedian $479 · 10th to 90th $112 to $3,311Professionalmedian $263 · 10th to 90th $105 to $1,096
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 $89.13 Median $229.09 Typical High $263.03 | Professional | None | $89.13 | $229.09 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,071.52 Typical High $3,235.94 | Facility | None | $323.59 | $1,071.52 | $3,235.94 |
AllWays Health Partners Setting Professional Modifier None Typical Low $120.23 Median $281.84 Typical High $1,737.80 | Professional | None | $120.23 | $281.84 | $1,737.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $138.04 Median $169.82 Typical High $316.23 | Facility | None | $138.04 | $169.82 | $316.23 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | None | $630.96 | $630.96 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $870.96 Typical High $1,258.93 | Facility | None | $446.68 | $870.96 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $288.40 Typical High $478.63 | Professional | None | $144.54 | $288.40 | $478.63 |
Fallon Health Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $3,311.31 | Facility | None | $95.50 | $125.89 | $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 $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 $104.71 Median $263.03 Typical High $645.65 | Professional | None | $104.71 | $263.03 | $645.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,071.52 Typical High $3,235.94 | Facility | None | $323.59 | $1,071.52 | $3,235.94 |
Mass General Brigham Setting Professional Modifier None Typical Low $120.23 Median $281.84 Typical High $1,737.80 | Professional | None | $120.23 | $281.84 | $1,737.80 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $5,128.61 | Facility | None | $575.44 | $1,380.38 | $5,128.61 |
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 $79.43 Median $181.97 Typical High $426.58 | Facility | None | $79.43 | $181.97 | $426.58 |
Well Sense Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $181.97 | Professional | None | $66.07 | $100.00 | $181.97 |
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 $44.67 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $44.67 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $17.78 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $66.07 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $13.18 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $8.91 | $22.91 | $26.30 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $63.10 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $42.66 | $63.10 | $120.23 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $87.10 Median $87.10 Typical High $117.49 | Professional | Q3 · Living kidney donor | $87.10 | $87.10 | $117.49 |
Where Massachusetts sits
The same service costs 4.2 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
$263
AK $468DC $112
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.