How much rates vary
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
AllWays Health Partners Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $3,548.13 | Facility | None | $363.08 | $794.33 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $60.26 Median $234.42 Typical High $15,135.61 | Professional | None | $60.26 | $234.42 | $15,135.61 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $588.84 Typical High $954.99 | Facility | None | $416.87 | $588.84 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $125.89 Median $154.88 Typical High $2,398.83 | Facility | None | $125.89 | $154.88 | $2,398.83 |
Fallon Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,511.89 | $3,090.30 | $3,715.35 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $316.23 Typical High $5,370.32 | Professional | None | $125.89 | $316.23 | $5,370.32 |
Mass General Brigham Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $3,548.13 | Facility | None | $363.08 | $794.33 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $60.26 Median $234.42 Typical High $15,135.61 | Professional | None | $60.26 | $234.42 | $15,135.61 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $37.15 Median $154.88 Typical High $489.78 | Professional | None | $37.15 | $154.88 | $489.78 |
Well Sense Setting Facility Modifier None Typical Low $21.88 Median $2,951.21 Typical High $4,897.79 | Facility | None | $21.88 | $2,951.21 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
4 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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.39 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Where Massachusetts sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 18th of 51
$363
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.