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 $38.90 Median $61.66 Typical High $190.55 | Facility | None | $38.90 | $61.66 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $72.44 | Professional | None | $38.90 | $61.66 | $72.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $35.48 Median $89.13 Typical High $281.84 | Facility | None | $35.48 | $89.13 | $281.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $407.38 | Professional | None | $46.77 | $100.00 | $407.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $89.13 | Facility | None | $38.02 | $38.02 | $89.13 |
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 $38.90 Median $47.86 Typical High $66.07 | Facility | None | $38.90 | $47.86 | $66.07 |
Fallon Health Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $131.83 | Professional | None | $83.18 | $100.00 | $131.83 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $41.69 Median $89.13 Typical High $181.97 | Professional | None | $41.69 | $89.13 | $181.97 |
Mass General Brigham Setting Facility Modifier None Typical Low $35.48 Median $89.13 Typical High $281.84 | Facility | None | $35.48 | $89.13 | $281.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $407.38 | Professional | None | $46.77 | $100.00 | $407.38 |
United Setting Facility Modifier None Typical Low $186.21 Median $354.81 Typical High $524.81 | Facility | None | $186.21 | $354.81 | $524.81 |
United Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $177.83 | Professional | None | $46.77 | $75.86 | $177.83 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $87.10 Typical High $128.82 | Facility | None | $64.57 | $87.10 | $128.82 |
Well Sense Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | None | $51.29 | $51.29 | $69.18 |
3 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 $19.05 Median $30.90 Typical High $33.11 | Professional | 52 · Reduced service | $19.05 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $9.12 Typical High $10.00 | Professional | 55 · Aftercare only | $5.75 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.17 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.89 | $6.17 | $6.61 |
Where Massachusetts sits
The same service costs 2.3 times more in Alaska 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· 3rd of 51
$87.10
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.