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 $79.43 Median $81.28 Typical High $114.82 | Facility | None | $79.43 | $81.28 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $123.03 | Professional | None | $81.28 | $97.72 | $123.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $263.03 | Facility | None | $70.79 | $74.13 | $263.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $239.88 | Professional | None | $64.57 | $109.65 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $169.82 | Professional | None | $72.44 | $104.71 | $169.82 |
Fallon Health Setting Facility Modifier None Typical Low $50.12 Median $89.13 Typical High $128.82 | Facility | None | $50.12 | $89.13 | $128.82 |
Fallon Health Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $128.82 | Professional | None | $48.98 | $79.43 | $128.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $263.03 | Professional | None | $70.79 | $104.71 | $263.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $263.03 | Facility | None | $70.79 | $74.13 | $263.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $239.88 | Professional | None | $64.57 | $109.65 | $239.88 |
United Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $263.03 | Professional | None | $70.79 | $107.15 | $263.03 |
Well Sense Setting Facility Modifier None Typical Low $56.23 Median $75.86 Typical High $114.82 | Facility | None | $56.23 | $75.86 | $114.82 |
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 $36.31 Median $40.74 Typical High $186.21 | Professional | 52 · Reduced service | $36.31 | $40.74 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.02 Typical High $56.23 | Professional | 55 · Aftercare only | $10.72 | $12.02 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.13 Typical High $37.15 | Professional | 56 · Pre-op care only | $7.24 | $8.13 | $37.15 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $75.86 Median $75.86 Typical High $79.43 | Facility | TD · Registered nurse | $75.86 | $75.86 | $79.43 |
Where Massachusetts sits
The same service costs 2.1 times more in Oregon than in Alabama. 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· 17th of 51
$91.20
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.