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 $69.18 Median $69.18 Typical High $74.13 | Facility | None | $69.18 | $69.18 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | None | $69.18 | $74.13 | $74.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $81.28 Median $245.47 Typical High $389.05 | Facility | None | $81.28 | $245.47 | $389.05 |
AllWays Health Partners Setting Professional Modifier None Typical Low $66.07 Median $190.55 Typical High $588.84 | Professional | None | $66.07 | $190.55 | $588.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $81.28 Median $169.82 Typical High $309.03 | Facility | None | $81.28 | $169.82 | $309.03 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $186.21 | Professional | None | $81.28 | $107.15 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $67.61 Typical High $123.03 | Facility | None | $61.66 | $67.61 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $97.72 Typical High $229.09 | Professional | None | $46.77 | $97.72 | $229.09 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $97.72 Typical High $3,630.78 | Facility | None | $83.18 | $97.72 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $186.21 | Professional | None | $114.82 | $138.04 | $186.21 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $229.09 | Professional | None | $66.07 | $104.71 | $229.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $81.28 Median $245.47 Typical High $389.05 | Facility | None | $81.28 | $245.47 | $389.05 |
Mass General Brigham Setting Professional Modifier None Typical Low $66.07 Median $190.55 Typical High $588.84 | Professional | None | $66.07 | $190.55 | $588.84 |
United Setting Facility Modifier None Typical Low $239.88 Median $446.68 Typical High $676.08 | Facility | None | $239.88 | $446.68 | $676.08 |
United Setting Professional Modifier None Typical Low $61.66 Median $102.33 Typical High $245.47 | Professional | None | $61.66 | $102.33 | $245.47 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $97.72 Typical High $154.88 | Facility | None | $70.79 | $97.72 | $154.88 |
Well Sense Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $85.11 | Professional | None | $66.07 | $70.79 | $85.11 |
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 $34.67 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $34.67 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.80 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $11.22 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $7.41 |
Where Massachusetts sits
The same service costs 5.0 times more in Alaska than in Alabama. 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· 19th of 51
$112
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.