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 $52.48 Median $52.48 Typical High $138.04 | Facility | None | $52.48 | $52.48 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | None | $52.48 | $52.48 | $54.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $57.54 Median $138.04 Typical High $190.55 | Facility | None | $57.54 | $138.04 | $190.55 |
AllWays Health Partners Setting Professional Modifier None Typical Low $34.67 Median $67.61 Typical High $398.11 | Professional | None | $34.67 | $67.61 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Fallon Health Setting Facility Modifier None Typical Low $74.13 Median $91.20 Typical High $213.80 | Facility | None | $74.13 | $91.20 | $213.80 |
Fallon Health Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $134.90 | Professional | None | $85.11 | $100.00 | $134.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $27.54 Median $52.48 Typical High $169.82 | Professional | None | $27.54 | $52.48 | $169.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $57.54 Median $138.04 Typical High $190.55 | Facility | None | $57.54 | $138.04 | $190.55 |
Mass General Brigham Setting Professional Modifier None Typical Low $34.67 Median $67.61 Typical High $398.11 | Professional | None | $34.67 | $67.61 | $398.11 |
United Setting Facility Modifier None Typical Low $40.74 Median $75.86 Typical High $114.82 | Facility | None | $40.74 | $75.86 | $114.82 |
United Setting Professional Modifier None Typical Low $17.38 Median $41.69 Typical High $89.13 | Professional | None | $17.38 | $41.69 | $89.13 |
Well Sense Setting Facility Modifier None Typical Low $44.67 Median $61.66 Typical High $91.20 | Facility | None | $44.67 | $61.66 | $91.20 |
Well Sense Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | None | $36.31 | $36.31 | $48.98 |
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 $26.30 Median $26.30 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $11.22 | Professional | 53 · Discontinued | $10.47 | $10.47 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $8.32 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.50 |
Where Massachusetts sits
The same service costs 2.6 times more in Alaska than in Utah. 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
$63.10
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.