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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | None | $47.86 | $47.86 | $57.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $51.29 | Facility | None | $45.71 | $45.71 | $51.29 |
AllWays Health Partners Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $147.91 | Professional | None | $51.29 | $64.57 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $67.61 | Professional | None | $46.77 | $51.29 | $67.61 |
Fallon Health Setting Facility Modifier None Typical Low $53.70 Median $72.44 Typical High $91.20 | Facility | None | $53.70 | $72.44 | $91.20 |
Fallon Health Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $85.11 | Professional | None | $56.23 | $72.44 | $85.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $147.91 | Professional | None | $51.29 | $61.66 | $147.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $51.29 | Facility | None | $45.71 | $45.71 | $51.29 |
Mass General Brigham Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $147.91 | Professional | None | $51.29 | $64.57 | $147.91 |
United Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $147.91 | Professional | None | $51.29 | $64.57 | $147.91 |
Well Sense Setting Facility Modifier None Typical Low $35.48 Median $47.86 Typical High $72.44 | Facility | None | $35.48 | $47.86 | $72.44 |
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 $23.99 Median $23.99 Typical High $28.84 | Professional | 52 · Reduced service | $23.99 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.77 Typical High $11.48 | Professional | 53 · Discontinued | $9.55 | $9.77 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $8.51 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.75 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $50.12 Median $50.12 Typical High $56.23 | Facility | TD · Registered nurse | $50.12 | $50.12 | $56.23 |
Where Massachusetts sits
The same service costs 4.9 times more in Alabama than in Louisiana. 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· 12th of 51
$64.57
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.