How much rates vary
Facilitymedian $832 · 10th to 90th $93 to $4,169Professionalmedian $240 · 10th to 90th $105 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 $416.87 Median $2,691.53 Typical High $3,715.35 | Facility | None | $416.87 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $234.42 | Professional | None | $91.20 | $144.54 | $234.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $436.52 Median $1,819.70 Typical High $5,128.61 | Facility | None | $436.52 | $1,819.70 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $1,412.54 | Professional | None | $123.03 | $257.04 | $1,412.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $218.78 | Facility | None | $93.33 | $93.33 | $218.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $91.20 Median $269.15 Typical High $1,737.80 | Professional | None | $91.20 | $269.15 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $1,905.46 Typical High $2,754.23 | Facility | None | $199.53 | $1,905.46 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $407.38 | Professional | None | $144.54 | $251.19 | $407.38 |
Fallon Health Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $3,311.31 | Facility | None | $87.10 | $120.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $398.11 | Professional | None | $251.19 | $295.12 | $398.11 |
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 $104.71 Median $234.42 Typical High $537.03 | Professional | None | $104.71 | $234.42 | $537.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $436.52 Median $1,819.70 Typical High $5,128.61 | Facility | None | $436.52 | $1,819.70 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $1,412.54 | Professional | None | $123.03 | $257.04 | $1,412.54 |
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 $104.71 Median $223.87 Typical High $501.19 | Professional | None | $104.71 | $223.87 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $79.43 Median $154.88 Typical High $933.25 | Facility | None | $79.43 | $154.88 | $933.25 |
Well Sense Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $123.03 | Professional | None | $67.61 | $100.00 | $123.03 |
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 $45.71 Median $72.44 Typical High $107.15 | Professional | 52 · Reduced service | $45.71 | $72.44 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $42.66 | Professional | 53 · Discontinued | $18.20 | $28.84 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $109.65 Typical High $158.49 | Professional | 54 · Surgery only | $67.61 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.88 Typical High $31.62 | Professional | 55 · Aftercare only | $13.49 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $21.38 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $64.57 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $42.66 | $64.57 | $83.18 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | Q3 · Living kidney donor | $93.33 | $93.33 | $125.89 |
Where Massachusetts sits
The same service costs 3.6 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
$240
AK $407DC $112
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.