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 $245.47 Median $245.47 Typical High $426.58 | Facility | None | $245.47 | $245.47 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $707.95 Typical High $812.83 | Facility | None | $602.56 | $707.95 | $812.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $426.58 | Professional | None | $239.88 | $288.40 | $426.58 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $245.47 Median $275.42 Typical High $501.19 | Facility | None | $245.47 | $275.42 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $1,737.80 | Facility | None | $512.86 | $831.76 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $501.19 | Professional | None | $398.11 | $398.11 | $501.19 |
Fallon Health Setting Facility Modifier None Typical Low $239.88 Median $316.23 Typical High $363.08 | Facility | None | $239.88 | $316.23 | $363.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $426.58 | Professional | None | $208.93 | $275.42 | $426.58 |
Health New England Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $1,513.56 | Facility | None | $741.31 | $758.58 | $1,513.56 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $707.95 Typical High $812.83 | Facility | None | $602.56 | $707.95 | $812.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $426.58 | Professional | None | $239.88 | $288.40 | $426.58 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $426.58 | Professional | None | $239.88 | $363.08 | $426.58 |
Well Sense Setting Facility Modifier None Typical Low $269.15 Median $338.84 Typical High $562.34 | Facility | None | $269.15 | $338.84 | $562.34 |
Well Sense Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | None | $245.47 | $245.47 | $295.12 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where Massachusetts sits
The same service costs 8.7 times more in Alabama 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· 19th of 51
$316
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.