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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $109.65 Median $316.23 Typical High $363.08 | Facility | None | $109.65 | $316.23 | $363.08 |
AllWays Health Partners Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $177.83 | Professional | None | $109.65 | $131.83 | $177.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $147.91 Median $169.82 Typical High $302.00 | Facility | None | $147.91 | $169.82 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $602.56 | Facility | None | $177.83 | $288.40 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | None | $138.04 | $138.04 | $147.91 |
Fallon Health Setting Facility Modifier None Typical Low $48.98 Median $57.54 Typical High $5,888.44 | Facility | None | $48.98 | $57.54 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | None | $48.98 | $48.98 | $57.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $199.53 | Professional | None | $102.33 | $131.83 | $199.53 |
Mass General Brigham Setting Facility Modifier None Typical Low $109.65 Median $316.23 Typical High $363.08 | Facility | None | $109.65 | $316.23 | $363.08 |
Mass General Brigham Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $177.83 | Professional | None | $109.65 | $131.83 | $177.83 |
United Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $177.83 | Professional | None | $117.49 | $141.25 | $177.83 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $295.12 | Facility | None | $131.83 | $177.83 | $295.12 |
Well Sense Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | None | $125.89 | $125.89 | $151.36 |
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 $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where Massachusetts sits
The same service costs 5.1 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· 7th of 51
$141
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.