How much rates vary
Facilitymedian $3,311 · 10th to 90th $407 to $6,166Professionalmedian $7,079 · 10th to 90th $3,802 to $33,113
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 $2,691.53 Median $3,388.44 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,388.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $5,754.40 | Professional | None | $3,801.89 | $3,801.89 | $5,754.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $9,549.93 | Facility | None | $346.74 | $1,047.13 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4,168.69 Median $10,964.78 Typical High $33,113.11 | Professional | None | $4,168.69 | $10,964.78 | $33,113.11 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $10,000.00 | Professional | None | $5,011.87 | $6,606.93 | $10,000.00 |
Fallon Health Setting Facility Modifier None Typical Low $3,311.31 Median $5,248.07 Typical High $6,165.95 | Facility | None | $3,311.31 | $5,248.07 | $6,165.95 |
Fallon Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $7,413.10 | Professional | None | $4,786.30 | $5,623.41 | $7,413.10 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4,786.30 Median $8,912.51 Typical High $12,882.50 | Professional | None | $4,786.30 | $8,912.51 | $12,882.50 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $9,549.93 | Facility | None | $346.74 | $1,047.13 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $4,168.69 Median $10,964.78 Typical High $33,113.11 | Professional | None | $4,168.69 | $10,964.78 | $33,113.11 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $4,168.69 Median $5,754.40 Typical High $16,218.10 | Professional | None | $4,168.69 | $5,754.40 | $16,218.10 |
Well Sense Setting Facility Modifier None Typical Low $3,090.30 Median $4,265.80 Typical High $6,309.57 | Facility | None | $3,090.30 | $4,265.80 | $6,309.57 |
Well Sense Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,818.38 | $2,818.38 | $3,801.89 |
9 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 $1,905.46 Median $1,905.46 Typical High $2,818.38 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $1,148.15 | Professional | 53 · Discontinued | $758.58 | $758.58 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,818.38 Typical High $4,265.80 | Professional | 54 · Surgery only | $2,818.38 | $2,818.38 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $562.34 Typical High $851.14 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $575.44 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,630.27 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,630.27 | $3,981.07 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $2,691.53 Median $4,570.88 Typical High $6,165.95 | Professional | 62 · Two surgeons | $2,691.53 | $4,570.88 | $6,165.95 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $2,454.71 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $1,548.82 Median $1,548.82 Typical High $2,089.30 | Professional | Q3 · Living kidney donor | $1,548.82 | $1,548.82 | $2,089.30 |
Where Massachusetts sits
The same service costs 21.9 times more in Alaska than in Texas. 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· 13th of 51
$6,607
AK $14,125TX $646
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.