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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $309.03 Median $371.54 Typical High $1,096.48 | Facility | None | $309.03 | $371.54 | $1,096.48 |
AllWays Health Partners Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $691.83 | Facility | None | $338.84 | $380.19 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $1,479.11 | Facility | None | $436.52 | $707.95 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | None | $338.84 | $338.84 | $398.11 |
Fallon Health Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $512.86 | Facility | None | $331.13 | $436.52 | $512.86 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $549.54 | Professional | None | $331.13 | $338.84 | $549.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $309.03 Median $371.54 Typical High $1,096.48 | Facility | None | $309.03 | $371.54 | $1,096.48 |
Mass General Brigham Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
United Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $549.54 | Professional | None | $331.13 | $331.13 | $549.54 |
Well Sense Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $776.25 | Facility | None | $363.08 | $489.78 | $776.25 |
Well Sense Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | None | $338.84 | $338.84 | $407.38 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where Massachusetts sits
The same service costs 1.5 times more in Arizona than in Rhode Island. 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· 35th of 51
$339
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.