How much rates vary
Facilitymedian $275 · 10th to 90th $44 to $2,692Professionalmedian $170 · 10th to 90th $46 to $912
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 $169.82 Median $2,137.96 Typical High $3,630.78 | Facility | None | $169.82 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $107.15 Typical High $169.82 | Professional | None | $40.74 | $107.15 | $169.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $100.00 Median $724.44 Typical High $2,454.71 | Facility | None | $100.00 | $724.44 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $45.71 Median $213.80 Typical High $1,258.93 | Professional | None | $45.71 | $213.80 | $1,258.93 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $97.72 | Facility | None | $43.65 | $52.48 | $97.72 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $549.54 | Professional | None | $97.72 | $97.72 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $158.49 Typical High $398.11 | Professional | None | $66.07 | $158.49 | $398.11 |
Fallon Health Setting Facility Modifier None Typical Low $45.71 Median $56.23 Typical High $3,311.31 | Facility | None | $45.71 | $56.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $354.81 | Professional | None | $229.09 | $269.15 | $354.81 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $45.71 Median $162.18 Typical High $478.63 | Professional | None | $45.71 | $162.18 | $478.63 |
Mass General Brigham Setting Facility Modifier None Typical Low $100.00 Median $724.44 Typical High $2,454.71 | Facility | None | $100.00 | $724.44 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $45.71 Median $213.80 Typical High $1,258.93 | Professional | None | $45.71 | $213.80 | $1,258.93 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $45.71 Median $134.90 Typical High $467.74 | Professional | None | $45.71 | $134.90 | $467.74 |
Well Sense Setting Facility Modifier None Typical Low $30.20 Median $70.79 Typical High $208.93 | Facility | None | $30.20 | $70.79 | $208.93 |
Well Sense Setting Professional Modifier None Typical Low $28.18 Median $41.69 Typical High $120.23 | Professional | None | $28.18 | $41.69 | $120.23 |
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 $20.42 Median $53.70 Typical High $85.11 | Professional | 52 · Reduced service | $20.42 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $23.44 Typical High $33.88 | Professional | 53 · Discontinued | $8.13 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $89.13 Typical High $125.89 | Professional | 54 · Surgery only | $30.20 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $17.78 Typical High $25.70 | Professional | 55 · Aftercare only | $6.17 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $11.75 Typical High $16.98 | Professional | 56 · Pre-op care only | $4.07 | $11.75 | $16.98 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $17.78 Median $26.92 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $17.78 | $26.92 | $79.43 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $28.18 Median $28.18 Typical High $38.02 | Professional | Q3 · Living kidney donor | $28.18 | $28.18 | $38.02 |
Where Massachusetts sits
The same service costs 4.6 times more in Wisconsin 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
$174
WI $240DC $52.48
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.