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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $42.66 Median $125.89 Typical High $165.96 | Facility | None | $42.66 | $125.89 | $165.96 |
AllWays Health Partners Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $75.86 | Professional | None | $42.66 | $50.12 | $75.86 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $79.43 Median $91.20 Typical High $165.96 | Facility | None | $79.43 | $91.20 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Fallon Health Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $5,888.44 | Facility | None | $70.79 | $83.18 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | None | $70.79 | $70.79 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $75.86 | Professional | None | $40.74 | $50.12 | $75.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $42.66 Median $125.89 Typical High $165.96 | Facility | None | $42.66 | $125.89 | $165.96 |
Mass General Brigham Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $75.86 | Professional | None | $42.66 | $50.12 | $75.86 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $75.86 | Professional | None | $50.12 | $50.12 | $75.86 |
Well Sense Setting Facility Modifier None Typical Low $169.82 Median $3,090.30 Typical High $4,897.79 | Facility | None | $169.82 | $3,090.30 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where Massachusetts sits
The same service costs 2.0 times more in Oregon 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· 5th of 51
$61.66
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.