How much rates vary
Facilitymedian $66 · 10th to 90th $28 to $2,818Professionalmedian $115 · 10th to 90th $56 to $398
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 $114.82 Median $1,479.11 Typical High $3,235.94 | Facility | None | $114.82 | $1,479.11 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $162.18 | Professional | None | $81.28 | $114.82 | $162.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $630.96 Typical High $2,818.38 | Facility | None | $97.72 | $630.96 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $54.95 Median $144.54 Typical High $1,778.28 | Professional | None | $54.95 | $144.54 | $1,778.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $41.69 Median $50.12 Typical High $95.50 | Facility | None | $41.69 | $50.12 | $95.50 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $41.69 Median $93.33 Typical High $186.21 | Professional | None | $41.69 | $93.33 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $125.89 Typical High $204.17 | Professional | None | $57.54 | $125.89 | $204.17 |
Fallon Health Setting Facility Modifier None Typical Low $23.99 Median $46.77 Typical High $123.03 | Facility | None | $23.99 | $46.77 | $123.03 |
Fallon Health Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $162.18 | Professional | None | $61.66 | $104.71 | $162.18 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $48.98 Median $112.20 Typical High $257.04 | Professional | None | $48.98 | $112.20 | $257.04 |
Health New England Setting Facility Modifier None Typical Low $309.03 Median $1,778.28 Typical High $4,786.30 | Facility | None | $309.03 | $1,778.28 | $4,786.30 |
Health New England Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $630.96 Typical High $2,818.38 | Facility | None | $97.72 | $630.96 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $54.95 Median $144.54 Typical High $1,778.28 | Professional | None | $54.95 | $144.54 | $1,778.28 |
Tufts Setting Facility Modifier None Typical Low $426.58 Median $1,122.02 Typical High $39,810.72 | Facility | None | $426.58 | $1,122.02 | $39,810.72 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,041.74 Typical High $2,818.38 | Facility | None | $933.25 | $2,041.74 | $2,818.38 |
United Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $257.04 | Professional | None | $51.29 | $114.82 | $257.04 |
Well Sense Setting Facility Modifier None Typical Low $37.15 Median $67.61 Typical High $114.82 | Facility | None | $37.15 | $67.61 | $114.82 |
Well Sense Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $107.15 | Professional | None | $63.10 | $89.13 | $107.15 |
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 $40.74 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $40.74 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $22.91 Typical High $30.90 | Professional | 53 · Discontinued | $16.60 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $61.66 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.98 Typical High $23.44 | Professional | 55 · Aftercare only | $12.30 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.48 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.13 | $11.48 | $15.49 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $102.33 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $74.13 | $102.33 | $436.52 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $57.54 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $40.74 | $57.54 | $72.44 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $77.62 Median $77.62 Typical High $104.71 | Professional | Q3 · Living kidney donor | $77.62 | $77.62 | $104.71 |
Where Massachusetts sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 12th of 51
$115
NC $174FL $70.79
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.