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 $97.72 Median $97.72 Typical High $295.12 | Facility | None | $97.72 | $97.72 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $134.90 | Professional | None | $97.72 | $97.72 | $134.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $100.00 Typical High $309.03 | Facility | None | $93.33 | $100.00 | $309.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $398.11 | Professional | None | $100.00 | $147.91 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $144.54 | Professional | None | $102.33 | $112.20 | $144.54 |
Fallon Health Setting Facility Modifier None Typical Low $100.00 Median $147.91 Typical High $186.21 | Facility | None | $100.00 | $147.91 | $186.21 |
Fallon Health Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $181.97 | Professional | None | $114.82 | $151.36 | $181.97 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $398.11 | Professional | None | $114.82 | $144.54 | $398.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $100.00 Typical High $309.03 | Facility | None | $93.33 | $100.00 | $309.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $398.11 | Professional | None | $100.00 | $147.91 | $398.11 |
United Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $398.11 | Professional | None | $114.82 | $144.54 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $165.96 | Facility | None | $83.18 | $109.65 | $165.96 |
5 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 $48.98 Median $48.98 Typical High $67.61 | Professional | 52 · Reduced service | $48.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | 53 · Discontinued | $19.95 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $19.95 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $13.49 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $104.71 Median $104.71 Typical High $112.20 | Facility | TD · Registered nurse | $104.71 | $104.71 | $112.20 |
Where Massachusetts sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 15th of 51
$138
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.