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 $407.38 Median $407.38 Typical High $1,380.38 | Facility | None | $407.38 | $407.38 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | None | $407.38 | $407.38 | $467.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,949.84 | Facility | None | $1,288.25 | $1,445.44 | $1,949.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $467.74 Median $1,202.26 Typical High $3,630.78 | Professional | None | $467.74 | $1,202.26 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $1,412.54 | Professional | None | $549.54 | $602.56 | $1,412.54 |
Fallon Health Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $870.96 | Facility | None | $323.59 | $588.84 | $870.96 |
Fallon Health Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $870.96 | Professional | None | $331.13 | $588.84 | $870.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $489.78 Median $1,174.90 Typical High $1,621.81 | Professional | None | $489.78 | $1,174.90 | $1,621.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,949.84 | Facility | None | $1,288.25 | $1,445.44 | $1,949.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $467.74 Median $1,202.26 Typical High $3,630.78 | Professional | None | $467.74 | $1,202.26 | $3,630.78 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,621.81 | Professional | None | $446.68 | $575.44 | $1,621.81 |
Well Sense Setting Facility Modifier None Typical Low $371.54 Median $512.86 Typical High $758.58 | Facility | None | $371.54 | $512.86 | $758.58 |
Well Sense Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
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 $204.17 Median $204.17 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $46.77 |
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
$741
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.