How much rates vary
Facilitymedian $1,380 · 10th to 90th $562 to $5,012Professionalmedian $977 · 10th to 90th $525 to $4,169
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $776.25 | Professional | None | $524.81 | $524.81 | $776.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $5,128.61 | Facility | None | $501.19 | $1,819.70 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $575.44 Median $1,584.89 Typical High $4,168.69 | Professional | None | $575.44 | $1,584.89 | $4,168.69 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,737.80 | Professional | None | $602.56 | $602.56 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,905.46 Typical High $2,754.23 | Facility | None | $588.84 | $1,905.46 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,380.38 | Professional | None | $707.95 | $933.25 | $1,380.38 |
Fallon Health Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $3,311.31 | Facility | None | $616.60 | $794.33 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,122.02 | Professional | None | $707.95 | $831.76 | $1,122.02 |
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 $645.65 Median $1,288.25 Typical High $1,905.46 | Professional | None | $645.65 | $1,288.25 | $1,905.46 |
Mass General Brigham Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $5,128.61 | Facility | None | $501.19 | $1,819.70 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $575.44 Median $1,584.89 Typical High $4,168.69 | Professional | None | $575.44 | $1,584.89 | $4,168.69 |
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 $549.54 Median $776.25 Typical High $2,398.83 | Professional | None | $549.54 | $776.25 | $2,398.83 |
Well Sense Setting Facility Modifier None Typical Low $436.52 Median $645.65 Typical High $1,000.00 | Facility | None | $436.52 | $645.65 | $1,000.00 |
Well Sense Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
8 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 $263.03 Median $263.03 Typical High $389.05 | Professional | 52 · Reduced service | $263.03 | $263.03 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $154.88 | Professional | 53 · Discontinued | $104.71 | $104.71 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $389.05 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $117.49 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $77.62 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $537.03 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $309.03 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | Q3 · Living kidney donor | $245.47 | $245.47 | $331.13 |
Where Massachusetts sits
The same service costs 5.5 times more in Alaska than in Texas. 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
$1,047
AK $2,344TX $427
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.