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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | None | $194.98 | $194.98 | $223.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $177.83 Median $446.68 Typical High $575.44 | Facility | None | $177.83 | $446.68 | $575.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $288.40 | Professional | None | $177.83 | $218.78 | $288.40 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $478.63 | Facility | None | $229.09 | $263.03 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $389.05 Typical High $933.25 | Facility | None | $251.19 | $389.05 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | None | $213.80 | $213.80 | $257.04 |
Fallon Health Setting Facility Modifier None Typical Low $46.77 Median $93.33 Typical High $4,897.79 | Facility | None | $46.77 | $93.33 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $109.65 | Professional | None | $46.77 | $54.95 | $109.65 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $323.59 | Professional | None | $165.96 | $199.53 | $323.59 |
Health New England Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $1,513.56 | Facility | None | $194.98 | $309.03 | $1,513.56 |
Mass General Brigham Setting Facility Modifier None Typical Low $177.83 Median $446.68 Typical High $575.44 | Facility | None | $177.83 | $446.68 | $575.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $288.40 | Professional | None | $177.83 | $218.78 | $288.40 |
Tufts Setting Facility Modifier None Typical Low $81.28 Median $89.13 Typical High $524.81 | Facility | None | $81.28 | $89.13 | $524.81 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $288.40 | Professional | None | $190.55 | $229.09 | $288.40 |
Well Sense Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $478.63 | Facility | None | $213.80 | $288.40 | $478.63 |
Well Sense Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | None | $194.98 | $194.98 | $234.42 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where Massachusetts sits
The same service costs 549.5 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· 23rd of 51
$214
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.