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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | None | $74.13 | $74.13 | $81.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $204.17 Median $316.23 Typical High $331.13 | Facility | None | $204.17 | $316.23 | $331.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $6,025.60 | Professional | None | $125.89 | $125.89 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $269.15 Typical High $549.54 | Facility | None | $162.18 | $269.15 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Fallon Health Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $2,951.21 | Facility | None | $147.91 | $181.97 | $2,951.21 |
Fallon Health Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $251.19 | Professional | None | $154.88 | $199.53 | $251.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $363.08 | Professional | None | $125.89 | $154.88 | $363.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $204.17 Median $316.23 Typical High $331.13 | Facility | None | $204.17 | $316.23 | $331.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $6,025.60 | Professional | None | $125.89 | $125.89 | $6,025.60 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $194.98 | Professional | None | $125.89 | $125.89 | $194.98 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,630.78 | $4,897.79 |
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 $37.15 Median $37.15 Typical High $40.74 | Professional | 52 · Reduced service | $37.15 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $16.22 | Professional | 53 · Discontinued | $14.79 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $12.30 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $8.13 |
Where Massachusetts sits
The same service costs 26.9 times more in Kansas 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· 24th of 51
$126
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.