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 $23.44 Median $23.44 Typical High $107.15 | Facility | None | $23.44 | $23.44 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $107.15 | Professional | None | $23.44 | $23.44 | $107.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $6.76 Median $56.23 Typical High $169.82 | Facility | None | $6.76 | $56.23 | $169.82 |
AllWays Health Partners Setting Professional Modifier None Typical Low $21.38 Median $54.95 Typical High $331.13 | Professional | None | $21.38 | $54.95 | $331.13 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $35.48 | Professional | None | $33.88 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $38.02 Typical High $38.02 | Facility | None | $22.91 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $44.67 | Professional | None | $32.36 | $32.36 | $44.67 |
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 $21.38 Median $47.86 Typical High $52.48 | Professional | None | $21.38 | $47.86 | $52.48 |
Health New England Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.76 Median $56.23 Typical High $169.82 | Facility | None | $6.76 | $56.23 | $169.82 |
Mass General Brigham Setting Professional Modifier None Typical Low $21.38 Median $54.95 Typical High $331.13 | Professional | None | $21.38 | $54.95 | $331.13 |
United Setting Professional Modifier None Typical Low $18.20 Median $26.92 Typical High $52.48 | Professional | None | $18.20 | $26.92 | $52.48 |
Well Sense Setting Facility Modifier None Typical Low $44.67 Median $60.26 Typical High $89.13 | Facility | None | $44.67 | $60.26 | $89.13 |
Well Sense Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | None | $34.67 | $34.67 | $41.69 |
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 $3.55 Median $3.55 Typical High $16.22 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $10.72 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $10.72 |
Where Massachusetts sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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· 28th of 51
$38.02
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.