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 $57.54 Median $57.54 Typical High $75.86 | Facility | None | $57.54 | $57.54 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | None | $75.86 | $75.86 | $81.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $75.86 Median $186.21 Typical High $239.88 | Facility | None | $75.86 | $186.21 | $239.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $107.15 | Professional | None | $72.44 | $81.28 | $107.15 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $75.86 Median $85.11 Typical High $154.88 | Facility | None | $75.86 | $85.11 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $169.82 Typical High $354.81 | Facility | None | $104.71 | $169.82 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | None | $81.28 | $81.28 | $95.50 |
Fallon Health Setting Facility Modifier None Typical Low $75.86 Median $97.72 Typical High $112.20 | Facility | None | $75.86 | $97.72 | $112.20 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $138.04 | Professional | None | $69.18 | $81.28 | $138.04 |
Mass General Brigham Setting Facility Modifier None Typical Low $75.86 Median $186.21 Typical High $239.88 | Facility | None | $75.86 | $186.21 | $239.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $107.15 | Professional | None | $72.44 | $81.28 | $107.15 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $109.65 | Professional | None | $72.44 | $83.18 | $109.65 |
Well Sense Setting Facility Modifier None Typical Low $89.13 Median $104.71 Typical High $154.88 | Facility | None | $89.13 | $104.71 | $154.88 |
Well Sense Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | None | $75.86 | $75.86 | $91.20 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where Massachusetts sits
The same service costs 3.0 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· 29th of 51
$81.28
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.