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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | None | $51.29 | $51.29 | $57.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $61.66 Median $64.57 Typical High $70.79 | Facility | None | $61.66 | $64.57 | $70.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $63.10 Median $213.80 Typical High $363.08 | Professional | None | $63.10 | $213.80 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Fallon Health Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $2,951.21 | Facility | None | $79.43 | $93.33 | $2,951.21 |
Fallon Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | None | $79.43 | $79.43 | $93.33 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $63.10 Median $123.03 Typical High $173.78 | Professional | None | $63.10 | $123.03 | $173.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $61.66 Median $64.57 Typical High $70.79 | Facility | None | $61.66 | $64.57 | $70.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $63.10 Median $213.80 Typical High $363.08 | Professional | None | $63.10 | $213.80 | $363.08 |
United Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $213.80 | Professional | None | $56.23 | $75.86 | $213.80 |
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 $25.70 Median $25.70 Typical High $28.18 | Professional | 52 · Reduced service | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $11.48 | Professional | 53 · Discontinued | $10.23 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $8.51 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.75 |
Where Massachusetts sits
The same service costs 3.0 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
$97.72
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.