How much rates vary
Facilitymedian $1,479 · 10th to 90th $407 to $3,548Professionalmedian $2,239 · 10th to 90th $1,288 to $9,120
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 $3,090.30 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,288.25 | $1,995.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $3,630.78 | Facility | None | $346.74 | $1,023.29 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $9,120.11 | Professional | None | $1,318.26 | $3,548.13 | $9,120.11 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,380.38 | $2,041.74 | $3,162.28 |
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 $1,621.81 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,621.81 | $2,089.30 | $3,162.28 |
Fallon Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $3,311.31 | Facility | None | $1,380.38 | $1,737.80 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,513.56 | $1,819.70 | $2,398.83 |
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 $1,513.56 Median $2,818.38 Typical High $3,890.45 | Professional | None | $1,513.56 | $2,818.38 | $3,890.45 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $3,630.78 | Facility | None | $346.74 | $1,023.29 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $9,120.11 | Professional | None | $1,318.26 | $3,548.13 | $9,120.11 |
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 $1,348.96 Median $1,819.70 Typical High $5,495.41 | Professional | None | $1,348.96 | $1,819.70 | $5,495.41 |
Well Sense Setting Facility Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,995.26 | Facility | None | $977.24 | $1,348.96 | $1,995.26 |
Well Sense Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,230.27 | Professional | None | $912.01 | $912.01 | $1,230.27 |
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 $645.65 Median $645.65 Typical High $912.01 | Professional | 52 · Reduced service | $645.65 | $645.65 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $363.08 | Professional | 53 · Discontinued | $257.04 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,348.96 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $269.15 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,258.93 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,479.11 Typical High $1,995.26 | Professional | 62 · Two surgeons | $870.96 | $1,479.11 | $1,995.26 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $794.33 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | Q3 · Living kidney donor | $588.84 | $588.84 | $794.33 |
Where Massachusetts sits
The same service costs 5.0 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· 14th of 51
$2,089
AK $4,467TX $891
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.