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 $229.09 Median $229.09 Typical High $724.44 | Facility | None | $229.09 | $229.09 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $724.44 | Professional | None | $229.09 | $229.09 | $724.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $776.25 Median $870.96 Typical High $1,174.90 | Facility | None | $776.25 | $870.96 | $1,174.90 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $707.95 Typical High $1,905.46 | Professional | None | $263.03 | $707.95 | $1,905.46 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $602.56 | Professional | None | $354.81 | $354.81 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $831.76 | Professional | None | $323.59 | $363.08 | $831.76 |
Fallon Health Setting Facility Modifier None Typical Low $194.98 Median $346.74 Typical High $524.81 | Facility | None | $194.98 | $346.74 | $524.81 |
Fallon Health Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $524.81 | Professional | None | $199.53 | $346.74 | $524.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $263.03 Median $707.95 Typical High $891.25 | Professional | None | $263.03 | $707.95 | $891.25 |
Health New England Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $489.78 | Professional | None | $288.40 | $467.74 | $489.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $776.25 Median $870.96 Typical High $1,174.90 | Facility | None | $776.25 | $870.96 | $1,174.90 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $707.95 Typical High $1,905.46 | Professional | None | $263.03 | $707.95 | $1,905.46 |
Tufts Setting Professional Modifier None Typical Low $173.78 Median $426.58 Typical High $549.54 | Professional | None | $173.78 | $426.58 | $549.54 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $891.25 | Professional | None | $245.47 | $316.23 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $218.78 Median $302.00 Typical High $446.68 | Facility | None | $218.78 | $302.00 | $446.68 |
Well Sense Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
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 $112.20 Median $112.20 Typical High $162.18 | Professional | 52 · Reduced service | $112.20 | $112.20 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | 53 · Discontinued | $45.71 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $48.98 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $32.36 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $32.36 |
Where Massachusetts sits
The same service costs 2.8 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· 9th of 51
$437
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.