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 $19.50 Median $19.50 Typical High $89.13 | Facility | None | $19.50 | $19.50 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $89.13 | Professional | None | $19.50 | $19.50 | $89.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $38.90 Median $42.66 Typical High $138.04 | Facility | None | $38.90 | $42.66 | $138.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $17.38 Median $45.71 Typical High $223.87 | Professional | None | $17.38 | $45.71 | $223.87 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $66.07 | Facility | None | $21.88 | $21.88 | $66.07 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | None | $28.18 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $26.92 Typical High $26.92 | Facility | None | $15.14 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $31.62 | Professional | None | $22.91 | $22.91 | $31.62 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $16.98 Median $38.90 Typical High $43.65 | Professional | None | $16.98 | $38.90 | $43.65 |
Health New England Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $38.90 Median $42.66 Typical High $138.04 | Facility | None | $38.90 | $42.66 | $138.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $17.38 Median $45.71 Typical High $223.87 | Professional | None | $17.38 | $45.71 | $223.87 |
Tufts Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $37.15 | Professional | None | $28.18 | $28.18 | $37.15 |
United Setting Professional Modifier None Typical Low $14.79 Median $21.88 Typical High $43.65 | Professional | None | $14.79 | $21.88 | $43.65 |
Well Sense Setting Facility Modifier None Typical Low $37.15 Median $48.98 Typical High $72.44 | Facility | None | $37.15 | $48.98 | $72.44 |
Well Sense Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | None | $28.18 | $28.18 | $33.88 |
2 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 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $13.18 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $8.91 |
Where Massachusetts sits
The same service costs 2.5 times more in Idaho than in Kentucky. 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· 20th of 51
$28.84
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.