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 $38.90 Median $38.90 Typical High $158.49 | Facility | None | $38.90 | $38.90 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $158.49 | Professional | None | $38.90 | $38.90 | $158.49 |
AllWays Health Partners Setting Facility Modifier None Typical Low $109.65 Median $467.74 Typical High $1,819.70 | Facility | None | $109.65 | $467.74 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $42.66 Median $117.49 Typical High $660.69 | Professional | None | $42.66 | $117.49 | $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 $74.13 Median $74.13 Typical High $154.88 | Professional | None | $74.13 | $74.13 | $154.88 |
Fallon Health Setting Facility Modifier None Typical Low $44.67 Median $57.54 Typical High $3,311.31 | Facility | None | $44.67 | $57.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $69.18 | Professional | None | $46.77 | $54.95 | $69.18 |
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 $48.98 Median $91.20 Typical High $158.49 | Professional | None | $48.98 | $91.20 | $158.49 |
Mass General Brigham Setting Facility Modifier None Typical Low $109.65 Median $467.74 Typical High $1,819.70 | Facility | None | $109.65 | $467.74 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $42.66 Median $117.49 Typical High $660.69 | Professional | None | $42.66 | $117.49 | $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 $54.95 Median $74.13 Typical High $169.82 | Professional | None | $54.95 | $74.13 | $169.82 |
Well Sense Setting Facility Modifier None Typical Low $34.67 Median $46.77 Typical High $69.18 | Facility | None | $34.67 | $46.77 | $69.18 |
Well Sense Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $47.86 | Professional | None | $39.81 | $39.81 | $47.86 |
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 $19.50 Median $19.50 Typical High $79.43 | Professional | 52 · Reduced service | $19.50 | $19.50 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $31.62 | Professional | 53 · Discontinued | $7.76 | $7.76 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $23.44 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $15.85 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $15.85 |
Where Massachusetts sits
The same service costs 4.7 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· 17th of 51
$85.11
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.