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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $109.65 Median $131.83 Typical High $398.11 | Facility | None | $109.65 | $131.83 | $398.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $181.97 | Professional | None | $117.49 | $120.23 | $181.97 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $120.23 Median $138.04 Typical High $251.19 | Facility | None | $120.23 | $138.04 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $524.81 | Facility | None | $154.88 | $251.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | None | $120.23 | $120.23 | $138.04 |
Fallon Health Setting Facility Modifier None Typical Low $120.23 Median $158.49 Typical High $181.97 | Facility | None | $120.23 | $158.49 | $181.97 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | None | $120.23 | $120.23 | $204.17 |
Mass General Brigham Setting Facility Modifier None Typical Low $109.65 Median $131.83 Typical High $398.11 | Facility | None | $109.65 | $131.83 | $398.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $181.97 | Professional | None | $117.49 | $120.23 | $181.97 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $204.17 | Professional | None | $117.49 | $120.23 | $204.17 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $281.84 | Facility | None | $131.83 | $177.83 | $281.84 |
Well Sense Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | None | $120.23 | $120.23 | $144.54 |
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 $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 32nd of 51
$120
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.