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 $141.25 Median $141.25 Typical High $263.03 | Facility | None | $141.25 | $141.25 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $263.03 | Professional | None | $204.17 | $263.03 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $199.53 Median $588.84 Typical High $660.69 | Facility | None | $199.53 | $588.84 | $660.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $380.19 | Professional | None | $199.53 | $288.40 | $380.19 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $309.03 Median $346.74 Typical High $630.96 | Facility | None | $309.03 | $346.74 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $512.86 Typical High $1,258.93 | Facility | None | $338.84 | $512.86 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Fallon Health Setting Facility Modifier None Typical Low $53.70 Median $109.65 Typical High $4,897.79 | Facility | None | $53.70 | $109.65 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $128.82 | Professional | None | $53.70 | $64.57 | $128.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $436.52 | Professional | None | $223.87 | $288.40 | $436.52 |
Health New England Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $199.53 Median $588.84 Typical High $660.69 | Facility | None | $199.53 | $588.84 | $660.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $380.19 | Professional | None | $199.53 | $288.40 | $380.19 |
United Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $389.05 | Professional | None | $257.04 | $309.03 | $389.05 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $363.08 Typical High $537.03 | Facility | None | $263.03 | $363.08 | $537.03 |
Well Sense Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | None | $263.03 | $263.03 | $316.23 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where Massachusetts sits
The same service costs 3.9 times more in Arizona than in Montana. 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· 15th of 51
$288
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.