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 $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $158.49 Median $1,949.84 Typical High $4,365.16 | Facility | None | $158.49 | $1,949.84 | $4,365.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $870.96 | Professional | None | $93.33 | $194.98 | $870.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $158.49 | Facility | None | $67.61 | $67.61 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $288.40 | Professional | None | $85.11 | $154.88 | $288.40 |
Fallon Health Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $3,311.31 | Facility | None | $67.61 | $83.18 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $234.42 | Professional | None | $144.54 | $169.82 | $234.42 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,023.29 Median $3,388.44 Typical High $5,888.44 | Facility | None | $1,023.29 | $3,388.44 | $5,888.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $81.28 Median $169.82 Typical High $363.08 | Professional | None | $81.28 | $169.82 | $363.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $158.49 Median $1,949.84 Typical High $4,365.16 | Facility | None | $158.49 | $1,949.84 | $4,365.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $870.96 | Professional | None | $93.33 | $194.98 | $870.96 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,388.44 Typical High $5,888.44 | Facility | None | $1,023.29 | $3,388.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $501.19 | Professional | None | $93.33 | $169.82 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $61.66 Median $102.33 Typical High $144.54 | Facility | None | $61.66 | $102.33 | $144.54 |
Well Sense Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $3,019.95 | Professional | None | $52.48 | $63.10 | $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 $50.12 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Where Massachusetts sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 21st of 51
$170
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.