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 $51.29 Median $51.29 Typical High $138.04 | Facility | None | $51.29 | $51.29 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $63.10 | Professional | None | $44.67 | $51.29 | $63.10 |
AllWays Health Partners Setting Facility Modifier None Typical Low $79.43 Median $87.10 Typical High $117.49 | Facility | None | $79.43 | $87.10 | $117.49 |
AllWays Health Partners Setting Professional Modifier None Typical Low $42.66 Median $100.00 Typical High $331.13 | Professional | None | $42.66 | $100.00 | $331.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $81.28 | Facility | None | $35.48 | $35.48 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $107.15 | Professional | None | $40.74 | $42.66 | $107.15 |
Fallon Health Setting Facility Modifier None Typical Low $20.42 Median $39.81 Typical High $53.70 | Facility | None | $20.42 | $39.81 | $53.70 |
Fallon Health Setting Professional Modifier None Typical Low $24.55 Median $43.65 Typical High $63.10 | Professional | None | $24.55 | $43.65 | $63.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $39.81 Median $79.43 Typical High $109.65 | Professional | None | $39.81 | $79.43 | $109.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $79.43 Median $87.10 Typical High $117.49 | Facility | None | $79.43 | $87.10 | $117.49 |
Mass General Brigham Setting Professional Modifier None Typical Low $42.66 Median $100.00 Typical High $331.13 | Professional | None | $42.66 | $100.00 | $331.13 |
United Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $123.03 | Professional | None | $51.29 | $74.13 | $123.03 |
Well Sense Setting Facility Modifier None Typical Low $31.62 Median $42.66 Typical High $63.10 | Facility | None | $31.62 | $42.66 | $63.10 |
Well Sense Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | None | $38.90 | $38.90 | $46.77 |
3 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 $25.12 Median $25.12 Typical High $32.36 | Professional | 52 · Reduced service | $25.12 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $9.77 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $6.46 |
Where Massachusetts sits
The same service costs 2.6 times more in Nebraska 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· 10th of 51
$64.57
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.