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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | None | $66.07 | $66.07 | $70.79 |
AllWays Health Partners Setting Facility Modifier None Typical Low $74.13 Median $213.80 Typical High $245.47 | Facility | None | $74.13 | $213.80 | $245.47 |
AllWays Health Partners Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $109.65 | Professional | None | $74.13 | $77.62 | $109.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $162.18 | Facility | None | $77.62 | $89.13 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $151.36 Typical High $316.23 | Facility | None | $93.33 | $151.36 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | None | $72.44 | $72.44 | $91.20 |
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 $63.10 Median $77.62 Typical High $120.23 | Professional | None | $63.10 | $77.62 | $120.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $74.13 Median $213.80 Typical High $245.47 | Facility | None | $74.13 | $213.80 | $245.47 |
Mass General Brigham Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $109.65 | Professional | None | $74.13 | $77.62 | $109.65 |
United Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $112.20 | Professional | None | $74.13 | $77.62 | $112.20 |
Well Sense Setting Facility Modifier None Typical Low $66.07 Median $91.20 Typical High $134.90 | Facility | None | $66.07 | $91.20 | $134.90 |
Well Sense Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | None | $66.07 | $66.07 | $79.43 |
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 $33.11 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $6.61 |
Where Massachusetts sits
The same service costs 2.8 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· 20th of 51
$77.62
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.