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 $60.26 Median $63.10 Typical High $204.17 | Facility | None | $60.26 | $63.10 | $204.17 |
AllWays Health Partners Setting Professional Modifier None Typical Low $25.70 Median $67.61 Typical High $331.13 | Professional | None | $25.70 | $67.61 | $331.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $74.13 Median $85.11 Typical High $114.82 | Facility | None | $74.13 | $85.11 | $114.82 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
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 $64.57 | Professional | None | $25.12 | $57.54 | $64.57 |
Health New England Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $204.17 | Facility | None | $60.26 | $63.10 | $204.17 |
Mass General Brigham Setting Professional Modifier None Typical Low $25.70 Median $67.61 Typical High $331.13 | Professional | None | $25.70 | $67.61 | $331.13 |
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 $51.29 Median $66.07 Typical High $107.15 | Facility | None | $51.29 | $66.07 | $107.15 |
Well Sense Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $56.23 | Professional | None | $41.69 | $46.77 | $56.23 |
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 $14.45 Median $14.45 Typical High $66.07 | Professional | 52 · Reduced service | $14.45 | $14.45 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $26.30 | Professional | 53 · Discontinued | $5.75 | $5.75 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $19.50 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $19.50 |
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 2.3 times more in Kansas than in New Jersey. 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
$53.70
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.