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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | None | $199.53 | $199.53 | $208.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Facility | None | $141.25 | $141.25 | $147.91 |
AllWays Health Partners Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $630.96 | Professional | None | $213.80 | $302.00 | $630.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $457.09 Median $524.81 Typical High $707.95 | Facility | None | $457.09 | $524.81 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $234.42 | Professional | None | $144.54 | $144.54 | $234.42 |
Fallon Health Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $251.19 | Facility | None | $158.49 | $158.49 | $251.19 |
Fallon Health Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $251.19 | Professional | None | $173.78 | $213.80 | $251.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $588.84 | Professional | None | $162.18 | $245.47 | $588.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Facility | None | $141.25 | $141.25 | $147.91 |
Mass General Brigham Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $630.96 | Professional | None | $213.80 | $302.00 | $630.96 |
United Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $630.96 | Professional | None | $213.80 | $302.00 | $630.96 |
Well Sense Setting Facility Modifier None Typical Low $154.88 Median $208.93 Typical High $316.23 | Facility | None | $154.88 | $208.93 | $316.23 |
Well Sense Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | None | $141.25 | $141.25 | $169.82 |
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 $100.00 Median $100.00 Typical High $104.71 | Professional | 52 · Reduced service | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | 53 · Discontinued | $39.81 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $31.62 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $20.89 |
Where Massachusetts sits
The same service costs 4.7 times more in Alaska than in Alabama. 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· 23rd of 51
$214
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.