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 $234.42 Median $234.42 Typical High $363.08 | Facility | None | $234.42 | $234.42 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | None | $234.42 | $234.42 | $269.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $208.93 Median $257.04 Typical High $758.58 | Facility | None | $208.93 | $257.04 | $758.58 |
AllWays Health Partners Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $338.84 | Professional | None | $229.09 | $234.42 | $338.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $234.42 Median $263.03 Typical High $478.63 | Facility | None | $234.42 | $263.03 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $1,000.00 | Facility | None | $302.00 | $489.78 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | None | $234.42 | $234.42 | $275.42 |
Fallon Health Setting Facility Modifier None Typical Low $229.09 Median $302.00 Typical High $346.74 | Facility | None | $229.09 | $302.00 | $346.74 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $389.05 | Professional | None | $229.09 | $234.42 | $389.05 |
Mass General Brigham Setting Facility Modifier None Typical Low $208.93 Median $257.04 Typical High $758.58 | Facility | None | $208.93 | $257.04 | $758.58 |
Mass General Brigham Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $338.84 | Professional | None | $229.09 | $234.42 | $338.84 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $389.05 | Professional | None | $229.09 | $229.09 | $389.05 |
Well Sense Setting Facility Modifier None Typical Low $251.19 Median $323.59 Typical High $537.03 | Facility | None | $251.19 | $323.59 | $537.03 |
Well Sense Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | None | $234.42 | $234.42 | $281.84 |
2 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 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.99 |
Where Massachusetts sits
The same service costs 1.6 times more in Arizona than in Hawaii. 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
$234
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.