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 $66.07 Median $66.07 Typical High $95.50 | Facility | None | $66.07 | $66.07 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | None | $66.07 | $66.07 | $70.79 |
AllWays Health Partners Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $524.81 | Facility | None | $123.03 | $501.19 | $524.81 |
AllWays Health Partners Setting Professional Modifier None Typical Low $67.61 Median $147.91 Typical High $630.96 | Professional | None | $67.61 | $147.91 | $630.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $223.87 Median $416.87 Typical High $645.65 | Facility | None | $223.87 | $416.87 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $173.78 Typical High $363.08 | Facility | None | $107.15 | $173.78 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | None | $83.18 | $83.18 | $100.00 |
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 $36.31 Median $50.12 Typical High $147.91 | Professional | None | $36.31 | $50.12 | $147.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $524.81 | Facility | None | $123.03 | $501.19 | $524.81 |
Mass General Brigham Setting Professional Modifier None Typical Low $67.61 Median $147.91 Typical High $630.96 | Professional | None | $67.61 | $147.91 | $630.96 |
United Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $181.97 | Professional | None | $50.12 | $91.20 | $181.97 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,511.89 | $3,019.95 | $3,019.95 |
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 $33.11 Median $33.11 Typical High $35.48 | Professional | 52 · Reduced service | $33.11 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $7.08 |
Where Massachusetts sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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· 5th of 51
$117
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.