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 $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $23.99 | Professional | None | $21.38 | $21.38 | $23.99 |
AllWays Health Partners Setting Facility Modifier None Typical Low $25.70 Median $26.30 Typical High $28.84 | Facility | None | $25.70 | $26.30 | $28.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $25.70 Median $87.10 Typical High $151.36 | Professional | None | $25.70 | $87.10 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Fallon Health Setting Facility Modifier None Typical Low $33.11 Median $38.90 Typical High $2,951.21 | Facility | None | $33.11 | $38.90 | $2,951.21 |
Fallon Health Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.90 | Professional | None | $33.11 | $33.11 | $38.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $25.70 Median $51.29 Typical High $72.44 | Professional | None | $25.70 | $51.29 | $72.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $25.70 Median $26.30 Typical High $28.84 | Facility | None | $25.70 | $26.30 | $28.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $25.70 Median $87.10 Typical High $151.36 | Professional | None | $25.70 | $87.10 | $151.36 |
United Setting Professional Modifier None Typical Low $22.91 Median $30.90 Typical High $87.10 | Professional | None | $22.91 | $30.90 | $87.10 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,630.78 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
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 $10.72 Median $10.72 Typical High $11.75 | Professional | 52 · Reduced service | $10.72 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.79 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $3.55 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.40 |
Where Massachusetts sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 6th of 51
$38.90
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.