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 $112.20 Median $112.20 Typical High $331.13 | Facility | None | $112.20 | $112.20 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $138.04 | Professional | None | $112.20 | $112.20 | $138.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $398.11 | Facility | None | $263.03 | $295.12 | $398.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $120.23 Median $398.11 Typical High $691.83 | Professional | None | $120.23 | $398.11 | $691.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $263.03 Median $302.00 Typical High $407.38 | Facility | None | $263.03 | $302.00 | $407.38 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $269.15 | Professional | None | $120.23 | $204.17 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $309.03 | Professional | None | $128.82 | $128.82 | $309.03 |
Fallon Health Setting Facility Modifier None Typical Low $67.61 Median $123.03 Typical High $173.78 | Facility | None | $67.61 | $123.03 | $173.78 |
Fallon Health Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $173.78 | Professional | None | $66.07 | $120.23 | $173.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $316.23 | Professional | None | $128.82 | $181.97 | $316.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $398.11 | Facility | None | $263.03 | $295.12 | $398.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $120.23 Median $398.11 Typical High $691.83 | Professional | None | $120.23 | $398.11 | $691.83 |
United Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $426.58 | Professional | None | $117.49 | $158.49 | $426.58 |
Well Sense Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $165.96 | Facility | None | $79.43 | $109.65 | $165.96 |
Well Sense Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | None | $83.18 | $83.18 | $100.00 |
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 $56.23 Median $56.23 Typical High $69.18 | Professional | 52 · Reduced service | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $27.54 | Professional | 53 · Discontinued | $22.39 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $20.89 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $13.80 |
Where Massachusetts sits
The same service costs 2.8 times more in Alaska than in Texas. 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· 12th of 51
$162
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.