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 $44.67 Median $44.67 Typical High $97.72 | Facility | None | $44.67 | $44.67 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $44.67 | Professional | None | $37.15 | $44.67 | $44.67 |
AllWays Health Partners Setting Facility Modifier None Typical Low $79.43 Median $102.33 Typical High $125.89 | Facility | None | $79.43 | $102.33 | $125.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $21.38 Median $51.29 Typical High $269.15 | Professional | None | $21.38 | $51.29 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Fallon Health Setting Facility Modifier None Typical Low $46.77 Median $57.54 Typical High $134.90 | Facility | None | $46.77 | $57.54 | $134.90 |
Fallon Health Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $85.11 | Professional | None | $53.70 | $64.57 | $85.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.00 Median $33.11 Typical High $107.15 | Professional | None | $10.00 | $33.11 | $107.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $79.43 Median $102.33 Typical High $125.89 | Facility | None | $79.43 | $102.33 | $125.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $21.38 Median $51.29 Typical High $269.15 | Professional | None | $21.38 | $51.29 | $269.15 |
United Setting Facility Modifier None Typical Low $52.48 Median $97.72 Typical High $147.91 | Facility | None | $52.48 | $97.72 | $147.91 |
United Setting Professional Modifier None Typical Low $6.31 Median $29.51 Typical High $64.57 | Professional | None | $6.31 | $29.51 | $64.57 |
Well Sense Setting Facility Modifier None Typical Low $33.88 Median $46.77 Typical High $69.18 | Facility | None | $33.88 | $46.77 | $69.18 |
Well Sense Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
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 $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $18.62 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.41 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.72 | $4.47 | $4.47 |
Where Massachusetts sits
The same service costs 12.9 times more in Hawaii than in Kentucky. 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· 14th of 51
$46.77
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.