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 $58.88 Median $58.88 Typical High $234.42 | Facility | None | $58.88 | $58.88 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $234.42 | Professional | None | $58.88 | $58.88 | $234.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $147.91 Median $467.74 Typical High $1,819.70 | Facility | None | $147.91 | $467.74 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $74.13 Median $181.97 Typical High $660.69 | Professional | None | $74.13 | $181.97 | $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 $112.20 Median $112.20 Typical High $234.42 | Professional | None | $112.20 | $112.20 | $234.42 |
Fallon Health Setting Facility Modifier None Typical Low $67.61 Median $85.11 Typical High $3,311.31 | Facility | None | $67.61 | $85.11 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $104.71 | Professional | None | $72.44 | $85.11 | $104.71 |
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 $74.13 Median $138.04 Typical High $239.88 | Professional | None | $74.13 | $138.04 | $239.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $147.91 Median $467.74 Typical High $1,819.70 | Facility | None | $147.91 | $467.74 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $74.13 Median $181.97 Typical High $660.69 | Professional | None | $74.13 | $181.97 | $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 $83.18 Median $112.20 Typical High $257.04 | Professional | None | $83.18 | $112.20 | $257.04 |
Well Sense Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $104.71 | Facility | None | $52.48 | $69.18 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None | $60.26 | $60.26 | $72.44 |
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 $29.51 Median $29.51 Typical High $117.49 | Professional | 52 · Reduced service | $29.51 | $29.51 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $46.77 | Professional | 53 · Discontinued | $11.75 | $11.75 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $35.48 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $23.44 |
Where Massachusetts sits
The same service costs 4.5 times more in Wisconsin 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
$129
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.