How much rates vary
Facilitymedian $479 · 10th to 90th $87 to $3,311Professionalmedian $257 · 10th to 90th $91 to $1,175
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 $489.78 Median $2,238.72 Typical High $3,630.78 | Facility | None | $489.78 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $229.09 | Professional | None | $79.43 | $181.97 | $229.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $3,162.28 | Facility | None | $323.59 | $870.96 | $3,162.28 |
AllWays Health Partners Setting Professional Modifier None Typical Low $109.65 Median $288.40 Typical High $1,778.28 | Professional | None | $109.65 | $288.40 | $1,778.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $83.18 Median $102.33 Typical High $190.55 | Facility | None | $83.18 | $102.33 | $190.55 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $81.28 Median $346.74 Typical High $549.54 | Professional | None | $81.28 | $346.74 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $1,000.00 | Facility | None | $446.68 | $676.08 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $281.84 Typical High $501.19 | Professional | None | $128.82 | $281.84 | $501.19 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $3,311.31 | Facility | None | $83.18 | $109.65 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $501.19 | Professional | None | $323.59 | $380.19 | $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 $91.20 Median $251.19 Typical High $676.08 | Professional | None | $91.20 | $251.19 | $676.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $3,162.28 | Facility | None | $323.59 | $870.96 | $3,162.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $109.65 Median $288.40 Typical High $1,778.28 | Professional | None | $109.65 | $288.40 | $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 $91.20 Median $229.09 Typical High $645.65 | Professional | None | $91.20 | $229.09 | $645.65 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $194.98 Typical High $346.74 | Facility | None | $70.79 | $194.98 | $346.74 |
Well Sense Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $147.91 | Professional | None | $57.54 | $85.11 | $147.91 |
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 $39.81 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $39.81 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $15.85 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $134.90 Typical High $169.82 | Professional | 54 · Surgery only | $60.26 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $12.02 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $7.94 | $18.20 | $22.91 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $54.95 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $36.31 | $54.95 | $97.72 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | Q3 · Living kidney donor | $74.13 | $74.13 | $100.00 |
Where Massachusetts sits
The same service costs 4.1 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· 9th of 51
$257
AK $398DC $97.72
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.