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 $29.51 Median $29.51 Typical High $134.90 | Facility | None | $29.51 | $29.51 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $134.90 | Professional | None | $29.51 | $29.51 | $134.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $56.23 Median $64.57 Typical High $213.80 | Facility | None | $56.23 | $64.57 | $213.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $26.92 Median $69.18 Typical High $371.54 | Professional | None | $26.92 | $69.18 | $371.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $134.90 | Facility | None | $43.65 | $43.65 | $134.90 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $48.98 | Professional | None | $42.66 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $40.74 Typical High $40.74 | Facility | None | $23.44 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $47.86 | Professional | None | $34.67 | $34.67 | $47.86 |
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 $25.70 Median $60.26 Typical High $61.66 | Professional | None | $25.70 | $60.26 | $61.66 |
Mass General Brigham Setting Facility Modifier None Typical Low $56.23 Median $64.57 Typical High $213.80 | Facility | None | $56.23 | $64.57 | $213.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $26.92 Median $69.18 Typical High $371.54 | Professional | None | $26.92 | $69.18 | $371.54 |
United Setting Professional Modifier None Typical Low $22.91 Median $33.88 Typical High $66.07 | Professional | None | $22.91 | $33.88 | $66.07 |
Well Sense Setting Facility Modifier None Typical Low $56.23 Median $75.86 Typical High $112.20 | Facility | None | $56.23 | $75.86 | $112.20 |
Well Sense Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | None | $43.65 | $43.65 | $52.48 |
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 $4.47 Median $4.47 Typical High $20.42 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $13.49 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $13.49 |
Where Massachusetts sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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· 17th of 51
$48.98
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.