How much rates vary
Facilitymedian $275 · 10th to 90th $69 to $3,311Professionalmedian $200 · 10th to 90th $74 to $851
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 $371.54 Median $2,238.72 Typical High $3,630.78 | Facility | None | $371.54 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $194.98 | Professional | None | $64.57 | $131.83 | $194.98 |
AllWays Health Partners Setting Facility Modifier None Typical Low $154.88 Median $1,071.52 Typical High $3,548.13 | Facility | None | $154.88 | $1,071.52 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $87.10 Median $223.87 Typical High $1,348.96 | Professional | None | $87.10 | $223.87 | $1,348.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $162.18 | Facility | None | $69.18 | $69.18 | $162.18 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | None | $707.95 | $707.95 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $831.76 | Facility | None | $199.53 | $275.42 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $218.78 Typical High $398.11 | Professional | None | $104.71 | $218.78 | $398.11 |
Fallon Health Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $3,311.31 | Facility | None | $69.18 | $89.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $380.19 | Professional | None | $239.88 | $288.40 | $380.19 |
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 $74.13 Median $194.98 Typical High $512.86 | Professional | None | $74.13 | $194.98 | $512.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $154.88 Median $1,071.52 Typical High $3,548.13 | Facility | None | $154.88 | $1,071.52 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $87.10 Median $223.87 Typical High $1,348.96 | Professional | None | $87.10 | $223.87 | $1,348.96 |
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 $72.44 Median $173.78 Typical High $478.63 | Professional | None | $72.44 | $173.78 | $478.63 |
Well Sense Setting Facility Modifier None Typical Low $57.54 Median $95.50 Typical High $199.53 | Facility | None | $57.54 | $95.50 | $199.53 |
Well Sense Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $109.65 | Professional | None | $47.86 | $70.79 | $109.65 |
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 $32.36 Median $66.07 Typical High $95.50 | Professional | 52 · Reduced service | $32.36 | $66.07 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $26.92 Typical High $38.02 | Professional | 53 · Discontinued | $12.88 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $100.00 Typical High $144.54 | Professional | 54 · Surgery only | $47.86 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $19.95 Typical High $28.84 | Professional | 55 · Aftercare only | $9.55 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $13.18 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.46 | $13.18 | $19.05 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $95.50 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $54.95 | $95.50 | $125.89 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.20 Median $45.71 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $30.20 | $45.71 | $74.13 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | Q3 · Living kidney donor | $83.18 | $83.18 | $112.20 |
Where Massachusetts sits
The same service costs 3.7 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· 8th of 51
$200
AK $309DC $83.18
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.