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 $13.80 Median $13.80 Typical High $72.44 | Facility | None | $13.80 | $13.80 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $16.22 | Professional | None | $13.80 | $13.80 | $16.22 |
AllWays Health Partners Setting Facility Modifier None Typical Low $34.67 Median $37.15 Typical High $109.65 | Facility | None | $34.67 | $37.15 | $109.65 |
AllWays Health Partners Setting Professional Modifier None Typical Low $14.13 Median $31.62 Typical High $51.29 | Professional | None | $14.13 | $31.62 | $51.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $57.54 Median $66.07 Typical High $120.23 | Facility | None | $57.54 | $66.07 | $120.23 |
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 $21.38 Median $21.38 Typical High $30.20 | Professional | None | $21.38 | $21.38 | $30.20 |
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 $18.20 Median $32.36 Typical High $70.79 | Professional | None | $18.20 | $32.36 | $70.79 |
Mass General Brigham Setting Facility Modifier None Typical Low $34.67 Median $37.15 Typical High $109.65 | Facility | None | $34.67 | $37.15 | $109.65 |
Mass General Brigham Setting Professional Modifier None Typical Low $14.13 Median $31.62 Typical High $51.29 | Professional | None | $14.13 | $31.62 | $51.29 |
United Setting Professional Modifier None Typical Low $12.02 Median $24.55 Typical High $79.43 | Professional | None | $12.02 | $24.55 | $79.43 |
Well Sense Setting Facility Modifier None Typical Low $30.20 Median $40.74 Typical High $58.88 | Facility | None | $30.20 | $40.74 | $58.88 |
Well Sense Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $27.54 | Professional | None | $23.44 | $23.44 | $27.54 |
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 $2.04 Median $2.04 Typical High $2.45 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $1.62 |
Where Massachusetts sits
The same service costs 3.5 times more in Montana 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· 4th of 51
$37.15
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.