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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | None | $87.10 | $87.10 | $104.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $85.11 Median $213.80 Typical High $275.42 | Facility | None | $85.11 | $213.80 | $275.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $131.83 | Professional | None | $85.11 | $97.72 | $131.83 |
BCBS Setting Facility Modifier None Typical Low $97.72 Median $109.65 Typical High $199.53 | Facility | None | $97.72 | $109.65 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $199.53 Typical High $416.87 | Facility | None | $123.03 | $199.53 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | None | $95.50 | $95.50 | $114.82 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $173.78 Typical High $5,888.44 | Facility | None | $83.18 | $173.78 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $173.78 | Professional | None | $147.91 | $147.91 | $173.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $131.83 | Professional | None | $74.13 | $95.50 | $131.83 |
Health New England Setting Facility Modifier None Typical Low $302.00 Median $316.23 Typical High $331.13 | Facility | None | $302.00 | $316.23 | $331.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $85.11 Median $213.80 Typical High $275.42 | Facility | None | $85.11 | $213.80 | $275.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $131.83 | Professional | None | $85.11 | $97.72 | $131.83 |
United Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $131.83 | Professional | None | $85.11 | $128.82 | $131.83 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $177.83 | Facility | None | $87.10 | $120.23 | $177.83 |
Well Sense Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | None | $87.10 | $87.10 | $104.71 |
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 $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Where Massachusetts sits
The same service costs 1.7 times more in Texas than in Arkansas. 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· 12th of 51
$110
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.