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 $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $758.58 | Professional | None | $724.44 | $724.44 | $758.58 |
AllWays Health Partners Setting Facility Modifier None Typical Low $851.14 Median $2,041.74 Typical High $2,570.40 | Facility | None | $851.14 | $2,041.74 | $2,570.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $562.34 Median $1,584.89 Typical High $5,370.32 | Professional | None | $562.34 | $1,584.89 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $2,454.71 | Professional | None | $954.99 | $1,071.52 | $2,454.71 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $1,445.44 Typical High $5,888.44 | Facility | None | $83.18 | $1,445.44 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,230.27 | $1,445.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $562.34 Median $1,584.89 Typical High $2,454.71 | Professional | None | $562.34 | $1,584.89 | $2,454.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $851.14 Median $2,041.74 Typical High $2,570.40 | Facility | None | $851.14 | $2,041.74 | $2,570.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $562.34 Median $1,584.89 Typical High $5,370.32 | Professional | None | $562.34 | $1,584.89 | $5,370.32 |
United Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,584.89 | Professional | None | $478.63 | $741.31 | $1,584.89 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,630.78 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
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 $363.08 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $75.86 |
Where Massachusetts sits
The same service costs 3.5 times more in Alaska than in Arkansas. 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
$1,230
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.