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 $194.98 Median $194.98 Typical High $269.15 | Facility | None | $194.98 | $194.98 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | None | $194.98 | $194.98 | $199.53 |
AllWays Health Partners Setting Facility Modifier None Typical Low $144.54 Median $407.38 Typical High $537.03 | Facility | None | $144.54 | $407.38 | $537.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $281.84 | Professional | None | $162.18 | $213.80 | $281.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $467.74 | Facility | None | $229.09 | $257.04 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $380.19 Typical High $912.01 | Facility | None | $204.17 | $380.19 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | None | $213.80 | $213.80 | $234.42 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $288.40 | Professional | None | $138.04 | $204.17 | $288.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $144.54 Median $407.38 Typical High $537.03 | Facility | None | $144.54 | $407.38 | $537.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $281.84 | Professional | None | $162.18 | $213.80 | $281.84 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $288.40 | Professional | None | $190.55 | $229.09 | $288.40 |
Well Sense Setting Facility Modifier None Typical Low $229.09 Median $269.15 Typical High $398.11 | Facility | None | $229.09 | $269.15 | $398.11 |
Well Sense Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | None | $194.98 | $194.98 | $229.09 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where Massachusetts sits
The same service costs 1.9 times more in Arizona 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· 4th of 51
$229
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.