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 $29.51 Median $29.51 Typical High $53.70 | Facility | None | $29.51 | $29.51 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | None | $29.51 | $29.51 | $42.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $28.84 Median $74.13 Typical High $97.72 | Facility | None | $28.84 | $74.13 | $97.72 |
AllWays Health Partners Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $38.90 | Professional | None | $26.30 | $30.90 | $38.90 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $29.51 Median $33.88 Typical High $61.66 | Facility | None | $29.51 | $33.88 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $61.66 Typical High $125.89 | Facility | None | $38.02 | $61.66 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | None | $29.51 | $29.51 | $35.48 |
Fallon Health Setting Facility Modifier None Typical Low $30.90 Median $41.69 Typical High $61.66 | Facility | None | $30.90 | $41.69 | $61.66 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $25.12 Median $29.51 Typical High $47.86 | Professional | None | $25.12 | $29.51 | $47.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $28.84 Median $74.13 Typical High $97.72 | Facility | None | $28.84 | $74.13 | $97.72 |
Mass General Brigham Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $38.90 | Professional | None | $26.30 | $30.90 | $38.90 |
United Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
United Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $39.81 | Professional | None | $26.30 | $30.90 | $39.81 |
Well Sense Setting Facility Modifier None Typical Low $34.67 Median $40.74 Typical High $61.66 | Facility | None | $34.67 | $40.74 | $61.66 |
Well Sense Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | None | $29.51 | $29.51 | $35.48 |
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 $14.79 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $2.95 |
Where Massachusetts sits
Rates are fairly even across states for this service. 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· 16th of 51
$30.90
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.