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 $602.56 Median $602.56 Typical High $2,041.74 | Facility | None | $602.56 | $602.56 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $776.25 | Professional | None | $602.56 | $602.56 | $776.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $2,951.21 | Facility | None | $1,995.26 | $2,187.76 | $2,951.21 |
AllWays Health Partners Setting Professional Modifier None Typical Low $707.95 Median $1,819.70 Typical High $5,370.32 | Professional | None | $707.95 | $1,819.70 | $5,370.32 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $891.25 Median $1,548.82 Typical High $2,344.23 | Professional | None | $891.25 | $1,548.82 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $2,187.76 | Professional | None | $851.14 | $933.25 | $2,187.76 |
Fallon Health Setting Facility Modifier None Typical Low $501.19 Median $891.25 Typical High $1,318.26 | Facility | None | $501.19 | $891.25 | $1,318.26 |
Fallon Health Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,318.26 | Professional | None | $512.86 | $891.25 | $1,318.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $707.95 Median $1,778.28 Typical High $2,398.83 | Professional | None | $707.95 | $1,778.28 | $2,398.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $2,951.21 | Facility | None | $1,995.26 | $2,187.76 | $2,951.21 |
Mass General Brigham Setting Professional Modifier None Typical Low $707.95 Median $1,819.70 Typical High $5,370.32 | Professional | None | $707.95 | $1,819.70 | $5,370.32 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $2,398.83 | Professional | None | $660.69 | $851.14 | $2,398.83 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $776.25 Typical High $1,174.90 | Facility | None | $562.34 | $776.25 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
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 $302.00 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $69.18 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska than in New York. 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· 11th of 51
$1,122
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.