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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
AllWays Health Partners Setting Facility Modifier None Typical Low $83.18 Median $91.20 Typical High $288.40 | Facility | None | $83.18 | $91.20 | $288.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $47.86 Median $91.20 Typical High $489.78 | Professional | None | $47.86 | $91.20 | $489.78 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $85.11 Median $104.71 Typical High $141.25 | Facility | None | $85.11 | $104.71 | $141.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | None | $58.88 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | None | $54.95 | $54.95 | $64.57 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $34.67 Median $56.23 Typical High $87.10 | Professional | None | $34.67 | $56.23 | $87.10 |
Mass General Brigham Setting Facility Modifier None Typical Low $83.18 Median $91.20 Typical High $288.40 | Facility | None | $83.18 | $91.20 | $288.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $47.86 Median $91.20 Typical High $489.78 | Professional | None | $47.86 | $91.20 | $489.78 |
United Setting Professional Modifier None Typical Low $34.67 Median $56.23 Typical High $87.10 | Professional | None | $34.67 | $56.23 | $87.10 |
Well Sense Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $151.36 | Facility | None | $74.13 | $100.00 | $151.36 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
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 $18.62 Median $18.62 Typical High $21.88 | Professional | 52 · Reduced service | $18.62 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $8.71 | Professional | 53 · Discontinued | $7.41 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.46 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $4.37 |
Where Massachusetts sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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
$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.