How much rates vary
Facilitymedian $1,445 · 10th to 90th $575 to $5,012Professionalmedian $1,072 · 10th to 90th $575 to $4,467
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 $1,778.28 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $851.14 | Professional | None | $575.44 | $575.44 | $851.14 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $5,128.61 | Facility | None | $549.54 | $1,819.70 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $616.60 Median $1,698.24 Typical High $4,466.84 | Professional | None | $616.60 | $1,698.24 | $4,466.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,737.80 | Professional | None | $691.83 | $691.83 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,905.46 Typical High $2,754.23 | Facility | None | $676.08 | $1,905.46 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,513.56 | Professional | None | $758.58 | $1,000.00 | $1,513.56 |
Fallon Health Setting Facility Modifier None Typical Low $660.69 Median $870.96 Typical High $3,311.31 | Facility | None | $660.69 | $870.96 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,202.26 | Professional | None | $758.58 | $891.25 | $1,202.26 |
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 $707.95 Median $1,380.38 Typical High $2,041.74 | Professional | None | $707.95 | $1,380.38 | $2,041.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $5,128.61 | Facility | None | $549.54 | $1,819.70 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $616.60 Median $1,698.24 Typical High $4,466.84 | Professional | None | $616.60 | $1,698.24 | $4,466.84 |
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 $602.56 Median $851.14 Typical High $2,570.40 | Professional | None | $602.56 | $851.14 | $2,570.40 |
Well Sense Setting Facility Modifier None Typical Low $478.63 Median $691.83 Typical High $1,071.52 | Facility | None | $478.63 | $691.83 | $1,071.52 |
Well Sense Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | None | $407.38 | $407.38 | $549.54 |
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 $288.40 Median $288.40 Typical High $426.58 | Professional | 52 · Reduced service | $288.40 | $288.40 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $169.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $645.65 | Professional | 54 · Surgery only | $426.58 | $426.58 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $128.82 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $85.11 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $602.56 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $346.74 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $263.03 Median $263.03 Typical High $354.81 | Professional | Q3 · Living kidney donor | $263.03 | $263.03 | $354.81 |
Where Massachusetts sits
The same service costs 5.6 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· 11th of 51
$1,096
AK $2,512TX $447
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.