How much rates vary
Facilitymedian $479 · 10th to 90th $135 to $3,311Professionalmedian $288 · 10th to 90th $123 to $1,148
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 $114.82 Median $251.19 Typical High $281.84 | Professional | None | $114.82 | $251.19 | $281.84 |
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 $125.89 Median $309.03 Typical High $1,778.28 | Professional | None | $125.89 | $309.03 | $1,778.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $154.88 Median $186.21 Typical High $354.81 | Facility | None | $154.88 | $186.21 | $354.81 |
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 $177.83 Median $309.03 Typical High $512.86 | Professional | None | $177.83 | $309.03 | $512.86 |
Fallon Health Setting Facility Modifier None Typical Low $114.82 Median $147.91 Typical High $3,311.31 | Facility | None | $114.82 | $147.91 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $501.19 | Professional | None | $316.23 | $371.54 | $501.19 |
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 $123.03 Median $288.40 Typical High $676.08 | Professional | None | $123.03 | $288.40 | $676.08 |
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 $125.89 Median $309.03 Typical High $1,778.28 | Professional | None | $125.89 | $309.03 | $1,778.28 |
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 $123.03 Median $234.42 Typical High $630.96 | Professional | None | $123.03 | $234.42 | $630.96 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $190.55 Typical High $426.58 | Facility | None | $97.72 | $190.55 | $426.58 |
Well Sense Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $190.55 | Professional | None | $81.28 | $123.03 | $190.55 |
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 $57.54 Median $125.89 Typical High $138.04 | Professional | 52 · Reduced service | $57.54 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $50.12 Typical High $56.23 | Professional | 53 · Discontinued | $22.91 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $186.21 Typical High $208.93 | Professional | 54 · Surgery only | $87.10 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $17.38 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $25.12 Typical High $28.18 | Professional | 56 · Pre-op care only | $11.48 | $25.12 | $28.18 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $79.43 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $52.48 | $79.43 | $125.89 |
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 3.8 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· 10th of 51
$288
AK $490DC $129
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.