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 $33.11 Median $33.11 Typical High $41.69 | Facility | None | $33.11 | $33.11 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
AllWays Health Partners Setting Facility Modifier None Typical Low $33.11 Median $104.71 Typical High $138.04 | Facility | None | $33.11 | $104.71 | $138.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $66.07 | Professional | None | $41.69 | $44.67 | $66.07 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $41.69 Median $47.86 Typical High $87.10 | Facility | None | $41.69 | $47.86 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $87.10 Typical High $181.97 | Facility | None | $53.70 | $87.10 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | None | $41.69 | $41.69 | $60.26 |
Fallon Health Setting Facility Modifier None Typical Low $41.69 Median $56.23 Typical High $83.18 | Facility | None | $41.69 | $56.23 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $75.86 | Professional | None | $41.69 | $44.67 | $75.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $33.11 Median $104.71 Typical High $138.04 | Facility | None | $33.11 | $104.71 | $138.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $66.07 | Professional | None | $41.69 | $44.67 | $66.07 |
United Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $75.86 | Professional | None | $44.67 | $44.67 | $75.86 |
Well Sense Setting Facility Modifier None Typical Low $48.98 Median $61.66 Typical High $97.72 | Facility | None | $48.98 | $61.66 | $97.72 |
Well Sense Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | None | $41.69 | $41.69 | $50.12 |
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 $20.89 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.17 |
Where Massachusetts sits
The same service costs 1.8 times more in Arizona than in Georgia. 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· 18th of 51
$44.67
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.