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 $25.70 Median $25.70 Typical High $117.49 | Facility | None | $25.70 | $25.70 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | None | $25.70 | $25.70 | $28.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $77.62 Median $112.20 Typical High $676.08 | Facility | None | $77.62 | $112.20 | $676.08 |
AllWays Health Partners Setting Professional Modifier None Typical Low $20.89 Median $79.43 Typical High $245.47 | Professional | None | $20.89 | $79.43 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $138.04 Typical High $302.00 | Facility | None | $33.11 | $138.04 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $79.43 | Professional | None | $45.71 | $54.95 | $79.43 |
Fallon Health Setting Facility Modifier None Typical Low $10.47 Median $22.91 Typical High $45.71 | Facility | None | $10.47 | $22.91 | $45.71 |
Fallon Health Setting Professional Modifier None Typical Low $10.47 Median $22.91 Typical High $45.71 | Professional | None | $10.47 | $22.91 | $45.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $31.62 Median $66.07 Typical High $107.15 | Professional | None | $31.62 | $66.07 | $107.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $77.62 Median $112.20 Typical High $676.08 | Facility | None | $77.62 | $112.20 | $676.08 |
Mass General Brigham Setting Professional Modifier None Typical Low $20.89 Median $79.43 Typical High $245.47 | Professional | None | $20.89 | $79.43 | $245.47 |
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 $30.90 Median $52.48 Typical High $107.15 | Professional | None | $30.90 | $52.48 | $107.15 |
Well Sense Setting Facility Modifier None Typical Low $20.89 Median $29.51 Typical High $43.65 | Facility | None | $20.89 | $29.51 | $43.65 |
Well Sense Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | None | $21.88 | $21.88 | $26.30 |
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 $12.88 Median $12.88 Typical High $14.13 | Professional | 52 · Reduced service | $12.88 | $12.88 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.62 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.27 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.82 |
Where Massachusetts sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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· 6th of 51
$51.29
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.