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 $17.38 Median $17.38 Typical High $79.43 | Facility | None | $17.38 | $17.38 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $79.43 | Professional | None | $17.38 | $17.38 | $79.43 |
AllWays Health Partners Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $125.89 | Facility | None | $36.31 | $37.15 | $125.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $15.49 Median $39.81 Typical High $199.53 | Professional | None | $15.49 | $39.81 | $199.53 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $81.28 | Facility | None | $26.92 | $26.92 | $81.28 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $27.54 Median $28.18 Typical High $28.18 | Professional | None | $27.54 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $27.54 | Facility | None | $26.30 | $26.30 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $30.90 | Professional | None | $16.22 | $22.39 | $30.90 |
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 $15.14 Median $34.67 Typical High $35.48 | Professional | None | $15.14 | $34.67 | $35.48 |
Health New England Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $125.89 | Facility | None | $36.31 | $37.15 | $125.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $15.49 Median $39.81 Typical High $199.53 | Professional | None | $15.49 | $39.81 | $199.53 |
United Setting Professional Modifier None Typical Low $13.18 Median $19.50 Typical High $38.90 | Professional | None | $13.18 | $19.50 | $38.90 |
Well Sense Setting Facility Modifier None Typical Low $32.36 Median $43.65 Typical High $64.57 | Facility | None | $32.36 | $43.65 | $64.57 |
Well Sense Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $30.20 | Professional | None | $25.12 | $25.12 | $30.20 |
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 $2.57 Median $2.57 Typical High $11.75 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $7.94 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $7.94 |
Where Massachusetts sits
The same service costs 3.0 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· 18th of 51
$28.18
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.