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 $138.04 Median $138.04 Typical High $269.15 | Facility | None | $138.04 | $138.04 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $389.05 Typical High $457.09 | Facility | None | $331.13 | $389.05 | $457.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $213.80 | Professional | None | $138.04 | $162.18 | $213.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $138.04 Median $154.88 Typical High $281.84 | Facility | None | $138.04 | $154.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $794.33 | Facility | None | $218.78 | $331.13 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $208.93 | Professional | None | $181.97 | $181.97 | $208.93 |
Fallon Health Setting Facility Modifier None Typical Low $138.04 Median $181.97 Typical High $204.17 | Facility | None | $138.04 | $181.97 | $204.17 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $218.78 | Professional | None | $117.49 | $158.49 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $389.05 Typical High $457.09 | Facility | None | $331.13 | $389.05 | $457.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $213.80 | Professional | None | $138.04 | $162.18 | $213.80 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $213.80 | Professional | None | $141.25 | $199.53 | $213.80 |
Well Sense Setting Facility Modifier None Typical Low $154.88 Median $194.98 Typical High $316.23 | Facility | None | $154.88 | $194.98 | $316.23 |
Well Sense Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | None | $138.04 | $138.04 | $165.96 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where Massachusetts sits
The same service costs 1.8 times more in Arizona than in Rhode Island. 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
$178
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.