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 $2,691.53 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $537.03 | Professional | None | $257.04 | $257.04 | $537.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $154.88 Median $724.44 Typical High $3,548.13 | Facility | None | $154.88 | $724.44 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $177.83 Median $478.63 Typical High $5,370.32 | Professional | None | $177.83 | $478.63 | $5,370.32 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $446.68 | Professional | None | $208.93 | $295.12 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $630.96 | Professional | None | $269.15 | $269.15 | $630.96 |
Fallon Health Setting Facility Modifier None Typical Low $120.23 Median $239.88 Typical High $549.54 | Facility | None | $120.23 | $239.88 | $549.54 |
Fallon Health Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $302.00 | Professional | None | $120.23 | $223.87 | $302.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $549.54 | Professional | None | $194.98 | $363.08 | $549.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $154.88 Median $724.44 Typical High $3,548.13 | Facility | None | $154.88 | $724.44 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $177.83 Median $478.63 Typical High $5,370.32 | Professional | None | $177.83 | $478.63 | $5,370.32 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $758.58 | Professional | None | $190.55 | $263.03 | $758.58 |
Well Sense Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $281.84 | Facility | None | $158.49 | $199.53 | $281.84 |
Well Sense Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
3 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 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Where Massachusetts sits
The same service costs 10.5 times more in North Dakota 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· 36th of 51
$282
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.