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 $22.91 Median $39.81 Typical High $128.82 | Facility | None | $22.91 | $39.81 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $34.67 Typical High $39.81 | Professional | None | $22.91 | $34.67 | $39.81 |
AllWays Health Partners Setting Professional Modifier None Typical Low $17.78 Median $37.15 Typical High $245.47 | Professional | None | $17.78 | $37.15 | $245.47 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $21.88 Median $57.54 Typical High $77.62 | Facility | None | $21.88 | $57.54 | $77.62 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $16.98 Median $38.02 Typical High $38.02 | Professional | None | $16.98 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $33.11 Typical High $61.66 | Professional | None | $16.22 | $33.11 | $61.66 |
Fallon Health Setting Facility Modifier None Typical Low $12.30 Median $23.99 Typical High $38.02 | Facility | None | $12.30 | $23.99 | $38.02 |
Fallon Health Setting Professional Modifier None Typical Low $26.30 Median $47.86 Typical High $70.79 | Professional | None | $26.30 | $47.86 | $70.79 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $16.22 Median $33.11 Typical High $93.33 | Professional | None | $16.22 | $33.11 | $93.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $17.78 Median $37.15 Typical High $245.47 | Professional | None | $17.78 | $37.15 | $245.47 |
United Setting Professional Modifier None Typical Low $17.38 Median $32.36 Typical High $58.88 | Professional | None | $17.38 | $32.36 | $58.88 |
Well Sense Setting Facility Modifier None Typical Low $40.74 Median $51.29 Typical High $81.28 | Facility | None | $40.74 | $51.29 | $81.28 |
Well Sense Setting Professional Modifier None Typical Low $18.20 Median $34.67 Typical High $41.69 | Professional | None | $18.20 | $34.67 | $41.69 |
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 $11.48 Median $17.38 Typical High $19.95 | Professional | 52 · Reduced service | $11.48 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $6.92 Typical High $7.94 | Professional | 53 · Discontinued | $4.57 | $6.92 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $5.13 Typical High $6.03 | Professional | 55 · Aftercare only | $3.39 | $5.13 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.47 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.29 | $3.47 | $3.98 |
Well Sense Setting Facility Modifier RB · Replacement part Typical Low $15.14 Median $19.95 Typical High $35.48 | Facility | RB · Replacement part | $15.14 | $19.95 | $35.48 |
Where Massachusetts sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 27th of 51
$33.11
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.