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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $281.84 Median $707.95 Typical High $912.01 | Facility | None | $281.84 | $707.95 | $912.01 |
AllWays Health Partners Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $446.68 | Professional | None | $281.84 | $338.84 | $446.68 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $363.08 Median $416.87 Typical High $758.58 | Facility | None | $363.08 | $416.87 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $1,479.11 | Facility | None | $436.52 | $707.95 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | None | $338.84 | $338.84 | $380.19 |
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 $251.19 Median $338.84 Typical High $478.63 | Professional | None | $251.19 | $338.84 | $478.63 |
Mass General Brigham Setting Facility Modifier None Typical Low $281.84 Median $707.95 Typical High $912.01 | Facility | None | $281.84 | $707.95 | $912.01 |
Mass General Brigham Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $446.68 | Professional | None | $281.84 | $338.84 | $446.68 |
United Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $457.09 | Professional | None | $302.00 | $346.74 | $457.09 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $467.74 Typical High $3,630.78 | Facility | None | $346.74 | $467.74 | $3,630.78 |
Well Sense Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | None | $309.03 | $309.03 | $371.54 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
Where Massachusetts sits
The same service costs 22.9 times more in Arizona than in South Carolina. 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· 6th of 51
$347
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.