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 $34.67 Median $2,187.76 Typical High $3,630.78 | Facility | None | $34.67 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $26.92 | Professional | None | $21.38 | $21.38 | $26.92 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $102.33 | Facility | None | $50.12 | $66.07 | $102.33 |
AllWays Health Partners Setting Professional Modifier None Typical Low $14.13 Median $26.30 Typical High $77.62 | Professional | None | $14.13 | $26.30 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $75.86 Typical High $109.65 | Facility | None | $43.65 | $75.86 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $28.18 Typical High $85.11 | Professional | None | $23.44 | $28.18 | $85.11 |
Fallon Health Setting Facility Modifier None Typical Low $12.88 Median $23.44 Typical High $33.88 | Facility | None | $12.88 | $23.44 | $33.88 |
Fallon Health Setting Professional Modifier None Typical Low $12.59 Median $21.88 Typical High $31.62 | Professional | None | $12.59 | $21.88 | $31.62 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $19.50 Median $33.88 Typical High $95.50 | Professional | None | $19.50 | $33.88 | $95.50 |
Health New England Setting Facility Modifier None Typical Low $72.44 Median $95.50 Typical High $245.47 | Facility | None | $72.44 | $95.50 | $245.47 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $102.33 | Facility | None | $50.12 | $66.07 | $102.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $14.13 Median $26.30 Typical High $77.62 | Professional | None | $14.13 | $26.30 | $77.62 |
Tufts Setting Facility Modifier None Typical Low $14.13 Median $53.70 Typical High $112.20 | Facility | None | $14.13 | $53.70 | $112.20 |
United Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $186.21 | Facility | None | $66.07 | $123.03 | $186.21 |
United Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $79.43 | Professional | None | $24.55 | $33.88 | $79.43 |
Well Sense Setting Facility Modifier None Typical Low $14.13 Median $19.95 Typical High $29.51 | Facility | None | $14.13 | $19.95 | $29.51 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $10.72 Median $10.72 Typical High $10.96 | Professional | 52 · Reduced service | $10.72 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.19 |
Where Massachusetts sits
The same service costs 40.7 times more in Tennessee than in New York. 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· 35th of 51
$25.70
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.