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 $64.57 Median $64.57 Typical High $263.03 | Facility | None | $64.57 | $64.57 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $263.03 | Professional | None | $64.57 | $64.57 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $165.96 Median $467.74 Typical High $1,819.70 | Facility | None | $165.96 | $467.74 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $72.44 Median $199.53 Typical High $660.69 | Professional | None | $72.44 | $199.53 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $489.78 Typical High $831.76 | Facility | None | $446.68 | $489.78 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $257.04 | Professional | None | $123.03 | $123.03 | $257.04 |
Fallon Health Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $3,311.31 | Facility | None | $75.86 | $93.33 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $114.82 | Professional | None | $79.43 | $93.33 | $114.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $263.03 | Professional | None | $81.28 | $151.36 | $263.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $165.96 Median $467.74 Typical High $1,819.70 | Facility | None | $165.96 | $467.74 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $72.44 Median $199.53 Typical High $660.69 | Professional | None | $72.44 | $199.53 | $660.69 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $281.84 | Professional | None | $91.20 | $125.89 | $281.84 |
Well Sense Setting Facility Modifier None Typical Low $57.54 Median $77.62 Typical High $114.82 | Facility | None | $57.54 | $77.62 | $114.82 |
Well Sense Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | None | $66.07 | $66.07 | $79.43 |
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 $32.36 Median $32.36 Typical High $131.83 | Professional | 52 · Reduced service | $32.36 | $32.36 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $52.48 | Professional | 53 · Discontinued | $12.88 | $12.88 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $38.90 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $26.30 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $26.30 |
Where Massachusetts sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 16th of 51
$138
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.