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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $416.87 | Facility | None | $74.13 | $95.50 | $416.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $30.90 Median $60.26 Typical High $165.96 | Professional | None | $30.90 | $60.26 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $457.09 | Facility | None | $218.78 | $309.03 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $58.88 | Professional | None | $34.67 | $34.67 | $58.88 |
Fallon Health Setting Facility Modifier None Typical Low $17.38 Median $33.11 Typical High $56.23 | Facility | None | $17.38 | $33.11 | $56.23 |
Fallon Health Setting Professional Modifier None Typical Low $17.38 Median $29.51 Typical High $46.77 | Professional | None | $17.38 | $29.51 | $46.77 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $30.90 Median $56.23 Typical High $75.86 | Professional | None | $30.90 | $56.23 | $75.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $416.87 | Facility | None | $74.13 | $95.50 | $416.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $30.90 Median $60.26 Typical High $165.96 | Professional | None | $30.90 | $60.26 | $165.96 |
United Setting Facility Modifier None Typical Low $309.03 Median $575.44 Typical High $870.96 | Facility | None | $309.03 | $575.44 | $870.96 |
United Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $93.33 | Professional | None | $31.62 | $43.65 | $93.33 |
Well Sense Setting Facility Modifier None Typical Low $15.49 Median $21.38 Typical High $31.62 | Facility | None | $15.49 | $21.38 | $31.62 |
Well Sense Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.02 | Professional | None | $28.18 | $28.18 | $38.02 |
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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
Where Massachusetts sits
The same service costs 2.5 times more in Iowa than in Pennsylvania. 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· 7th of 51
$42.66
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.