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 $154.88 Median $154.88 Typical High $812.83 | Facility | None | $154.88 | $154.88 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | None | $154.88 | $154.88 | $181.97 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $1,230.27 | Facility | None | $354.81 | $416.87 | $1,230.27 |
AllWays Health Partners Setting Professional Modifier None Typical Low $134.90 Median $354.81 Typical High $575.44 | Professional | None | $134.90 | $354.81 | $575.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $645.65 Median $741.31 Typical High $1,348.96 | Facility | None | $645.65 | $741.31 | $1,348.96 |
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 $169.82 Median $169.82 Typical High $234.42 | Professional | None | $169.82 | $169.82 | $234.42 |
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 $204.17 Median $363.08 Typical High $776.25 | Professional | None | $204.17 | $363.08 | $776.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $1,230.27 | Facility | None | $354.81 | $416.87 | $1,230.27 |
Mass General Brigham Setting Professional Modifier None Typical Low $134.90 Median $354.81 Typical High $575.44 | Professional | None | $134.90 | $354.81 | $575.44 |
United Setting Professional Modifier None Typical Low $134.90 Median $275.42 Typical High $870.96 | Professional | None | $134.90 | $275.42 | $870.96 |
Well Sense Setting Facility Modifier None Typical Low $338.84 Median $457.09 Typical High $660.69 | Facility | None | $338.84 | $457.09 | $660.69 |
Well Sense Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | None | $257.04 | $257.04 | $309.03 |
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 $23.44 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $18.20 |
Where Massachusetts sits
The same service costs 3.2 times more in Iowa than in New York. 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· 19th of 51
$372
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.