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 $67.61 Median $67.61 Typical High $74.13 | Facility | None | $67.61 | $67.61 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | None | $67.61 | $67.61 | $74.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $67.61 Median $194.98 Typical High $223.87 | Facility | None | $67.61 | $194.98 | $223.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $100.00 | Professional | None | $66.07 | $74.13 | $100.00 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $32.36 Median $37.15 Typical High $66.07 | Facility | None | $32.36 | $37.15 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $131.83 Typical High $323.59 | Facility | None | $87.10 | $131.83 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $91.20 | Professional | None | $74.13 | $74.13 | $91.20 |
Fallon Health Setting Facility Modifier None Typical Low $13.18 Median $26.30 Typical High $4,897.79 | Facility | None | $13.18 | $26.30 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $30.90 | Professional | None | $13.18 | $15.49 | $30.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $123.03 | Professional | None | $57.54 | $74.13 | $123.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $67.61 Median $194.98 Typical High $223.87 | Facility | None | $67.61 | $194.98 | $223.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $100.00 | Professional | None | $66.07 | $74.13 | $100.00 |
United Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $100.00 | Professional | None | $66.07 | $79.43 | $100.00 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where Massachusetts sits
The same service costs 6.5 times more in Arizona than in Hawaii. 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· 36th of 51
$67.61
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.