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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $33.11 | Professional | None | $28.84 | $28.84 | $33.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $32.36 Median $43.65 Typical High $57.54 | Facility | None | $32.36 | $43.65 | $57.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $48.98 | Professional | None | $32.36 | $33.88 | $48.98 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $33.88 Median $38.90 Typical High $70.79 | Facility | None | $33.88 | $38.90 | $70.79 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $67.61 Typical High $138.04 | Facility | None | $40.74 | $67.61 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $39.81 | Professional | None | $31.62 | $31.62 | $39.81 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $27.54 Median $33.88 Typical High $48.98 | Professional | None | $27.54 | $33.88 | $48.98 |
Mass General Brigham Setting Facility Modifier None Typical Low $32.36 Median $43.65 Typical High $57.54 | Facility | None | $32.36 | $43.65 | $57.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $48.98 | Professional | None | $32.36 | $33.88 | $48.98 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $48.98 | Professional | None | $32.36 | $33.88 | $48.98 |
Well Sense Setting Facility Modifier None Typical Low $33.88 Median $43.65 Typical High $57.54 | Facility | None | $33.88 | $43.65 | $57.54 |
Well Sense Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $34.67 | Professional | None | $28.84 | $28.84 | $34.67 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Where Massachusetts sits
The same service costs 1.6 times more in Arizona than in Georgia. 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· 14th of 51
$33.88
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.