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 $28.84 Median $28.84 Typical High $131.83 | Facility | None | $28.84 | $28.84 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $131.83 | Professional | None | $28.84 | $28.84 | $131.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $213.80 | Facility | None | $61.66 | $63.10 | $213.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $25.70 Median $67.61 Typical High $338.84 | Professional | None | $25.70 | $67.61 | $338.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $138.04 | Facility | None | $45.71 | $45.71 | $138.04 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $46.77 | Professional | None | $41.69 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $42.66 | Facility | None | $39.81 | $39.81 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
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 $25.12 Median $57.54 Typical High $60.26 | Professional | None | $25.12 | $57.54 | $60.26 |
Health New England Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Mass General Brigham Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $213.80 | Facility | None | $61.66 | $63.10 | $213.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $25.70 Median $67.61 Typical High $338.84 | Professional | None | $25.70 | $67.61 | $338.84 |
United Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $64.57 | Professional | None | $21.88 | $33.11 | $64.57 |
Well Sense Setting Facility Modifier None Typical Low $54.95 Median $72.44 Typical High $109.65 | Facility | None | $54.95 | $72.44 | $109.65 |
Well Sense Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $51.29 | Professional | None | $42.66 | $42.66 | $51.29 |
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 $4.37 Median $4.37 Typical High $19.95 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $13.18 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $13.18 |
Where Massachusetts sits
The same service costs 5.8 times more in Hawaii than in Kansas. 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· 19th of 51
$46.77
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.