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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $208.93 | Professional | None | $181.97 | $181.97 | $208.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $162.18 Median $398.11 Typical High $524.81 | Facility | None | $162.18 | $398.11 | $524.81 |
AllWays Health Partners Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $263.03 | Professional | None | $162.18 | $199.53 | $263.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $213.80 Median $239.88 Typical High $436.52 | Facility | None | $213.80 | $239.88 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $851.14 | Facility | None | $257.04 | $416.87 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | None | $199.53 | $199.53 | $218.78 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $5,888.44 | Facility | None | $83.18 | $426.58 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | None | $363.08 | $363.08 | $426.58 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $275.42 | Professional | None | $151.36 | $181.97 | $275.42 |
Health New England Setting Facility Modifier None Typical Low $169.82 Median $1,071.52 Typical High $1,288.25 | Facility | None | $169.82 | $1,071.52 | $1,288.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $162.18 Median $398.11 Typical High $524.81 | Facility | None | $162.18 | $398.11 | $524.81 |
Mass General Brigham Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $263.03 | Professional | None | $162.18 | $199.53 | $263.03 |
United Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $263.03 | Professional | None | $173.78 | $213.80 | $263.03 |
Well Sense Setting Facility Modifier None Typical Low $213.80 Median $251.19 Typical High $371.54 | Facility | None | $213.80 | $251.19 | $371.54 |
Well Sense Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | None | $181.97 | $181.97 | $213.80 |
2 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 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Where Massachusetts sits
The same service costs 562.3 times more in Montana 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· 5th 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.