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 $19.50 Median $36.31 Typical High $114.82 | Facility | None | $19.50 | $36.31 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $36.31 Typical High $42.66 | Professional | None | $19.50 | $36.31 | $42.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $17.38 Median $44.67 Typical High $281.84 | Facility | None | $17.38 | $44.67 | $281.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $23.44 Median $51.29 Typical High $245.47 | Professional | None | $23.44 | $51.29 | $245.47 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $44.67 | Facility | None | $19.05 | $19.05 | $44.67 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $19.05 Median $43.65 Typical High $45.71 | Professional | None | $19.05 | $43.65 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Fallon Health Setting Facility Modifier None Typical Low $19.50 Median $23.99 Typical High $36.31 | Facility | None | $19.50 | $23.99 | $36.31 |
Fallon Health Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $79.43 | Professional | None | $48.98 | $58.88 | $79.43 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $20.89 Median $46.77 Typical High $107.15 | Professional | None | $20.89 | $46.77 | $107.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $17.38 Median $44.67 Typical High $281.84 | Facility | None | $17.38 | $44.67 | $281.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $23.44 Median $51.29 Typical High $245.47 | Professional | None | $23.44 | $51.29 | $245.47 |
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 $22.91 Median $44.67 Typical High $107.15 | Professional | None | $22.91 | $44.67 | $107.15 |
Well Sense Setting Facility Modifier None Typical Low $30.90 Median $41.69 Typical High $63.10 | Facility | None | $30.90 | $41.69 | $63.10 |
Well Sense Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $40.74 | Professional | None | $30.20 | $30.20 | $40.74 |
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 $9.55 Median $18.20 Typical High $19.50 | Professional | 52 · Reduced service | $9.55 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $5.37 Typical High $5.75 | Professional | 55 · Aftercare only | $2.88 | $5.37 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $3.63 Typical High $3.89 | Professional | 56 · Pre-op care only | $1.95 | $3.63 | $3.89 |
Where Massachusetts sits
The same service costs 2.6 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· 4th 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.