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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | None | $30.90 | $30.90 | $32.36 |
AllWays Health Partners Setting Facility Modifier None Typical Low $43.65 Median $79.43 Typical High $107.15 | Facility | None | $43.65 | $79.43 | $107.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $43.65 | Professional | None | $24.55 | $28.18 | $43.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $23.44 Median $26.92 Typical High $47.86 | Facility | None | $23.44 | $26.92 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Fallon Health Setting Facility Modifier None Typical Low $44.67 Median $52.48 Typical High $5,888.44 | Facility | None | $44.67 | $52.48 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $19.95 Median $24.55 Typical High $38.02 | Professional | None | $19.95 | $24.55 | $38.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $43.65 Median $79.43 Typical High $107.15 | Facility | None | $43.65 | $79.43 | $107.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $43.65 | Professional | None | $24.55 | $28.18 | $43.65 |
United Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $36.31 | Professional | None | $24.55 | $27.54 | $36.31 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Where Massachusetts sits
The same service costs 2.2 times more in Oregon 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· 15th of 51
$32.36
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.