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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | None | $77.62 | $77.62 | $85.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $104.71 | Facility | None | $93.33 | $95.50 | $104.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $93.33 Median $316.23 Typical High $537.03 | Professional | None | $93.33 | $316.23 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Fallon Health Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $2,951.21 | Facility | None | $120.23 | $141.25 | $2,951.21 |
Fallon Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | None | $120.23 | $120.23 | $141.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $93.33 Median $181.97 Typical High $263.03 | Professional | None | $93.33 | $181.97 | $263.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $104.71 | Facility | None | $93.33 | $95.50 | $104.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $93.33 Median $316.23 Typical High $537.03 | Professional | None | $93.33 | $316.23 | $537.03 |
United Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $316.23 | Professional | None | $83.18 | $112.20 | $316.23 |
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 $38.90 Median $38.90 Typical High $42.66 | Professional | 52 · Reduced service | $38.90 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | 53 · Discontinued | $15.49 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $12.88 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $8.51 |
Where Massachusetts sits
The same service costs 3.6 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· 7th of 51
$145
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.