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 $30.90 Median $93.33 Typical High $257.04 | Facility | None | $30.90 | $93.33 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $79.43 Typical High $93.33 | Professional | None | $30.90 | $79.43 | $93.33 |
AllWays Health Partners Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $141.25 | Facility | None | $67.61 | $87.10 | $141.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $28.18 Median $74.13 Typical High $645.65 | Professional | None | $28.18 | $74.13 | $645.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $28.84 Median $89.13 Typical High $128.82 | Facility | None | $28.84 | $89.13 | $128.82 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $22.91 Median $52.48 Typical High $93.33 | Professional | None | $22.91 | $52.48 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $52.48 Typical High $120.23 | Professional | None | $25.70 | $52.48 | $120.23 |
Fallon Health Setting Facility Modifier None Typical Low $16.60 Median $32.36 Typical High $51.29 | Facility | None | $16.60 | $32.36 | $51.29 |
Fallon Health Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $173.78 | Professional | None | $64.57 | $117.49 | $173.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $21.88 Median $67.61 Typical High $223.87 | Professional | None | $21.88 | $67.61 | $223.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $141.25 | Facility | None | $67.61 | $87.10 | $141.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $28.18 Median $74.13 Typical High $645.65 | Professional | None | $28.18 | $74.13 | $645.65 |
United Setting Facility Modifier None Typical Low $186.21 Median $354.81 Typical High $524.81 | Facility | None | $186.21 | $354.81 | $524.81 |
United Setting Professional Modifier None Typical Low $26.92 Median $46.77 Typical High $131.83 | Professional | None | $26.92 | $46.77 | $131.83 |
Well Sense Setting Facility Modifier None Typical Low $27.54 Median $53.70 Typical High $134.90 | Facility | None | $27.54 | $53.70 | $134.90 |
Well Sense Setting Professional Modifier None Typical Low $26.92 Median $67.61 Typical High $81.28 | Professional | None | $26.92 | $67.61 | $81.28 |
5 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 $15.49 Median $39.81 Typical High $46.77 | Professional | 52 · Reduced service | $15.49 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $16.22 Typical High $18.62 | Professional | 53 · Discontinued | $6.31 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $4.68 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $7.94 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.16 | $7.94 | $9.33 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Massachusetts sits
The same service costs 3.5 times more in Hawaii than in Maryland. 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· 26th of 51
$64.57
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.