How much rates vary
Facilitymedian $417 · 10th to 90th $200 to $2,630Professionalmedian $479 · 10th to 90th $186 to $1,738
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 $251.19 Median $2,691.53 Typical High $5,128.61 | Facility | None | $251.19 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $338.84 | Professional | None | $128.82 | $251.19 | $338.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $724.44 Typical High $2,454.71 | Facility | None | $275.42 | $724.44 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $204.17 Median $562.34 Typical High $2,630.27 | Professional | None | $204.17 | $562.34 | $2,630.27 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $524.81 | Facility | None | $229.09 | $275.42 | $524.81 |
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 $100.00 Median $549.54 Typical High $831.76 | Facility | None | $100.00 | $549.54 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $758.58 | Professional | None | $309.03 | $467.74 | $758.58 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $281.84 Typical High $3,311.31 | Facility | None | $177.83 | $281.84 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $758.58 | Professional | None | $457.09 | $562.34 | $758.58 |
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 $234.42 Median $501.19 Typical High $1,000.00 | Professional | None | $234.42 | $501.19 | $1,000.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $724.44 Typical High $2,454.71 | Facility | None | $275.42 | $724.44 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $204.17 Median $562.34 Typical High $2,630.27 | Professional | None | $204.17 | $562.34 | $2,630.27 |
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 $177.83 Median $354.81 Typical High $1,023.29 | Professional | None | $177.83 | $354.81 | $1,023.29 |
Well Sense Setting Facility Modifier None Typical Low $158.49 Median $245.47 Typical High $380.19 | Facility | None | $158.49 | $245.47 | $380.19 |
Well Sense Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $186.21 | Professional | None | $89.13 | $131.83 | $186.21 |
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 $64.57 Median $125.89 Typical High $169.82 | Professional | 52 · Reduced service | $64.57 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $50.12 Typical High $67.61 | Professional | 53 · Discontinued | $25.70 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $186.21 Typical High $251.19 | Professional | 54 · Surgery only | $97.72 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $37.15 Typical High $50.12 | Professional | 55 · Aftercare only | $19.50 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $25.12 Typical High $33.88 | Professional | 56 · Pre-op care only | $12.88 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $173.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $91.20 | $173.78 | $234.42 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $85.11 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $56.23 | $85.11 | $123.03 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | Q3 · Living kidney donor | $51.29 | $51.29 | $69.18 |
Where Massachusetts sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 5th of 51
$479
AK $741KY $166
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.