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 $40.74 Median $47.86 Typical High $109.65 | Facility | None | $40.74 | $47.86 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | None | $40.74 | $40.74 | $52.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $27.54 Median $102.33 Typical High $131.83 | Facility | None | $27.54 | $102.33 | $131.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $69.18 | Professional | None | $40.74 | $52.48 | $69.18 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $83.18 | Facility | None | $40.74 | $46.77 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $223.87 | Facility | None | $66.07 | $107.15 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $51.29 | Professional | None | $38.90 | $51.29 | $51.29 |
Fallon Health Setting Facility Modifier None Typical Low $40.74 Median $56.23 Typical High $81.28 | Facility | None | $40.74 | $56.23 | $81.28 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $69.18 | Professional | None | $34.67 | $51.29 | $69.18 |
Health New England Setting Facility Modifier None Typical Low $44.67 Median $125.89 Typical High $186.21 | Facility | None | $44.67 | $125.89 | $186.21 |
Mass General Brigham Setting Facility Modifier None Typical Low $27.54 Median $102.33 Typical High $131.83 | Facility | None | $27.54 | $102.33 | $131.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $69.18 | Professional | None | $40.74 | $52.48 | $69.18 |
United Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $69.18 | Professional | None | $45.71 | $52.48 | $69.18 |
Well Sense Setting Facility Modifier None Typical Low $42.66 Median $57.54 Typical High $95.50 | Facility | None | $42.66 | $57.54 | $95.50 |
Well Sense Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | None | $40.74 | $40.74 | $48.98 |
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 $20.42 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.07 |
Where Massachusetts sits
The same service costs 6.0 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· 9th of 51
$51.29
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.