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 $31.62 Median $31.62 Typical High $165.96 | Facility | None | $31.62 | $31.62 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $37.15 | Professional | None | $31.62 | $31.62 | $37.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $269.15 | Facility | None | $79.43 | $85.11 | $269.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $32.36 Median $74.13 Typical High $120.23 | Professional | None | $32.36 | $74.13 | $120.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $134.90 Median $151.36 Typical High $275.42 | Facility | None | $134.90 | $151.36 | $275.42 |
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 $0.09 Median $0.09 Typical High $0.12 | Professional | None | $0.09 | $0.09 | $0.12 |
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 $41.69 Median $75.86 Typical High $162.18 | Professional | None | $41.69 | $75.86 | $162.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $269.15 | Facility | None | $79.43 | $85.11 | $269.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $32.36 Median $74.13 Typical High $120.23 | Professional | None | $32.36 | $74.13 | $120.23 |
United Setting Professional Modifier None Typical Low $27.54 Median $56.23 Typical High $181.97 | Professional | None | $27.54 | $56.23 | $181.97 |
Well Sense Setting Facility Modifier None Typical Low $69.18 Median $93.33 Typical High $138.04 | Facility | None | $69.18 | $93.33 | $138.04 |
Well Sense Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | None | $53.70 | $53.70 | $64.57 |
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 $4.79 Median $4.79 Typical High $5.62 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.72 |
Where Massachusetts sits
The same service costs 5.5 times more in Iowa 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· 17th of 51
$81.28
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.