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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | None | $186.21 | $186.21 | $208.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Facility | None | $186.21 | $186.21 | $208.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $870.96 | Professional | None | $229.09 | $309.03 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $331.13 | Professional | None | $181.97 | $213.80 | $331.13 |
Fallon Health Setting Facility Modifier None Typical Low $295.12 Median $354.81 Typical High $5,888.44 | Facility | None | $295.12 | $354.81 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | None | $295.12 | $295.12 | $354.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $870.96 | Professional | None | $229.09 | $302.00 | $870.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Facility | None | $186.21 | $186.21 | $208.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $870.96 | Professional | None | $229.09 | $309.03 | $870.96 |
United Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $870.96 | Professional | None | $229.09 | $309.03 | $870.96 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,311.31 | $4,897.79 |
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 $93.33 Median $93.33 Typical High $104.71 | Professional | 52 · Reduced service | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $37.15 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $20.89 |
Where Massachusetts sits
The same service costs 6.6 times more in Alabama 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· 9th of 51
$295
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.