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 $19.05 Median $19.05 Typical High $87.10 | Facility | None | $19.05 | $19.05 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $38.02 | Professional | None | $19.05 | $19.05 | $38.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $40.74 Median $43.65 Typical High $134.90 | Facility | None | $40.74 | $43.65 | $134.90 |
AllWays Health Partners Setting Professional Modifier None Typical Low $15.14 Median $37.15 Typical High $218.78 | Professional | None | $15.14 | $37.15 | $218.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $30.20 | Professional | None | $28.18 | $28.18 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.90 | Professional | None | $21.88 | $21.88 | $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 $38.02 Typical High $38.02 | Professional | None | $15.14 | $38.02 | $38.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $40.74 Median $43.65 Typical High $134.90 | Facility | None | $40.74 | $43.65 | $134.90 |
Mass General Brigham Setting Professional Modifier None Typical Low $15.14 Median $37.15 Typical High $218.78 | Professional | None | $15.14 | $37.15 | $218.78 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $18.62 | Professional | None | $15.14 | $15.14 | $18.62 |
Well Sense Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $74.13 | Facility | None | $36.31 | $50.12 | $74.13 |
Well Sense Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | None | $27.54 | $27.54 | $33.11 |
4 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 52 · Reduced service Typical Low $9.55 Median $9.55 Typical High $43.65 | Professional | 52 · Reduced service | $9.55 | $9.55 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $17.38 | Professional | 53 · Discontinued | $3.80 | $3.80 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $12.88 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $8.71 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $8.71 |
Where Massachusetts sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 24th of 51
$22.39
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.