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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | None | $89.13 | $89.13 | $100.00 |
AllWays Health Partners Setting Professional Modifier None Typical Low $138.04 Median $467.74 Typical High $5,011.87 | Professional | None | $138.04 | $467.74 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $354.81 Typical High $5,888.44 | Facility | None | $83.18 | $354.81 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | None | $302.00 | $302.00 | $354.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $141.25 Median $380.19 Typical High $812.83 | Professional | None | $141.25 | $380.19 | $812.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $138.04 Median $467.74 Typical High $5,011.87 | Professional | None | $138.04 | $467.74 | $5,011.87 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $5,495.41 Typical High $8,128.31 | Facility | None | $2,884.03 | $5,495.41 | $8,128.31 |
United Setting Professional Modifier None Typical Low $100.00 Median $245.47 Typical High $2,290.87 | Professional | None | $100.00 | $245.47 | $2,290.87 |
Well Sense Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $44.67 Median $44.67 Typical High $50.12 | Professional | 52 · Reduced service | $44.67 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $19.95 | Professional | 53 · Discontinued | $17.78 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $10.00 |
Where Massachusetts sits
The same service costs 7.6 times more in Colorado than in Rhode Island. 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
$288
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.