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 $26.30 Median $26.30 Typical High $138.04 | Facility | None | $26.30 | $26.30 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | None | $26.30 | $26.30 | $30.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $66.07 Median $70.79 Typical High $223.87 | Facility | None | $66.07 | $70.79 | $223.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $26.92 Median $61.66 Typical High $100.00 | Professional | None | $26.92 | $61.66 | $100.00 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $112.20 Median $125.89 Typical High $229.09 | Facility | None | $112.20 | $125.89 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $37.15 Typical High $37.15 | Facility | None | $34.67 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Fallon Health Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $8,511.38 | Facility | None | $60.26 | $100.00 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $34.67 Median $63.10 Typical High $134.90 | Professional | None | $34.67 | $63.10 | $134.90 |
Mass General Brigham Setting Facility Modifier None Typical Low $66.07 Median $70.79 Typical High $223.87 | Facility | None | $66.07 | $70.79 | $223.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $26.92 Median $61.66 Typical High $100.00 | Professional | None | $26.92 | $61.66 | $100.00 |
United Setting Professional Modifier None Typical Low $22.91 Median $46.77 Typical High $151.36 | Professional | None | $22.91 | $46.77 | $151.36 |
Well Sense Setting Facility Modifier None Typical Low $57.54 Median $77.62 Typical High $114.82 | Facility | None | $57.54 | $77.62 | $114.82 |
Well Sense Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | None | $44.67 | $44.67 | $53.70 |
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 $3.98 Median $3.98 Typical High $4.68 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $3.09 |
Where Massachusetts sits
The same service costs 5.2 times more in Montana than in Kansas. 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· 14th of 51
$67.61
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.