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 $263.03 Median $263.03 Typical High $380.19 | Facility | None | $263.03 | $263.03 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $234.42 Median $398.11 Typical High $776.25 | Facility | None | $234.42 | $398.11 | $776.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $1,412.54 | Professional | None | $234.42 | $323.59 | $1,412.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $302.00 Median $338.84 Typical High $616.60 | Facility | None | $302.00 | $338.84 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $478.63 Typical High $1,174.90 | Facility | None | $257.04 | $478.63 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $363.08 Typical High $6,918.31 | Facility | None | $83.18 | $363.08 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | None | $257.04 | $263.03 | $263.03 |
Health New England Setting Facility Modifier None Typical Low $93,325.43 Median $93,325.43 Typical High $97,723.72 | Facility | None | $93,325.43 | $93,325.43 | $97,723.72 |
Mass General Brigham Setting Facility Modifier None Typical Low $234.42 Median $398.11 Typical High $776.25 | Facility | None | $234.42 | $398.11 | $776.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $1,412.54 | Professional | None | $234.42 | $323.59 | $1,412.54 |
United Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | None | $257.04 | $257.04 | $309.03 |
Well Sense Setting Facility Modifier None Typical Low $309.03 Median $407.38 Typical High $2,290.87 | Facility | None | $309.03 | $407.38 | $2,290.87 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where Massachusetts sits
The same service costs 1.7 times more in Alaska than in Indiana. 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· 32nd of 51
$263
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.