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 $169.82 Median $169.82 Typical High $281.84 | Facility | None | $169.82 | $169.82 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $281.84 | Professional | None | $169.82 | $169.82 | $281.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $158.49 Median $426.58 Typical High $562.34 | Facility | None | $158.49 | $426.58 | $562.34 |
AllWays Health Partners Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $245.47 | Professional | None | $165.96 | $190.55 | $245.47 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $169.82 Median $194.98 Typical High $354.81 | Facility | None | $169.82 | $194.98 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $398.11 Typical High $954.99 | Facility | None | $257.04 | $398.11 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $263.03 | Professional | None | $218.78 | $218.78 | $263.03 |
Fallon Health Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $257.04 | Facility | None | $169.82 | $223.87 | $257.04 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $363.08 | Professional | None | $186.21 | $223.87 | $363.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $158.49 Median $426.58 Typical High $562.34 | Facility | None | $158.49 | $426.58 | $562.34 |
Mass General Brigham Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $245.47 | Professional | None | $165.96 | $190.55 | $245.47 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $245.47 | Professional | None | $165.96 | $234.42 | $245.47 |
Well Sense Setting Facility Modifier None Typical Low $181.97 Median $239.88 Typical High $398.11 | Facility | None | $181.97 | $239.88 | $398.11 |
Well Sense Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | None | $169.82 | $169.82 | $204.17 |
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 $85.11 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $16.98 |
Where Massachusetts sits
The same service costs 1.8 times more in Arizona than in Alabama. 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· 17th of 51
$219
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.