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 $32.36 Median $32.36 Typical High $54.95 | Facility | None | $32.36 | $32.36 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | None | $32.36 | $32.36 | $37.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $30.20 Median $87.10 Typical High $100.00 | Facility | None | $30.20 | $87.10 | $100.00 |
AllWays Health Partners Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $45.71 | Professional | None | $30.20 | $34.67 | $45.71 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $38.02 Median $42.66 Typical High $77.62 | Facility | None | $38.02 | $42.66 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $63.10 Typical High $151.36 | Facility | None | $41.69 | $63.10 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $42.66 | Professional | None | $35.48 | $35.48 | $42.66 |
Fallon Health Setting Facility Modifier None Typical Low $18.20 Median $36.31 Typical High $4,897.79 | Facility | None | $18.20 | $36.31 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $18.20 Median $21.38 Typical High $42.66 | Professional | None | $18.20 | $21.38 | $42.66 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $26.92 Median $34.67 Typical High $57.54 | Professional | None | $26.92 | $34.67 | $57.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $30.20 Median $87.10 Typical High $100.00 | Facility | None | $30.20 | $87.10 | $100.00 |
Mass General Brigham Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $45.71 | Professional | None | $30.20 | $34.67 | $45.71 |
United Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $46.77 | Professional | None | $30.90 | $38.02 | $46.77 |
Well Sense Setting Facility Modifier None Typical Low $35.48 Median $48.98 Typical High $81.28 | Facility | None | $35.48 | $48.98 | $81.28 |
Well Sense Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | None | $31.62 | $31.62 | $38.02 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where Massachusetts sits
The same service costs 97.7 times more in Arizona 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· 10th of 51
$38.02
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.