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 $43.65 Median $63.10 Typical High $194.98 | Facility | None | $43.65 | $63.10 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | None | $43.65 | $43.65 | $45.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $77.62 Median $109.65 Typical High $144.54 | Facility | None | $77.62 | $109.65 | $144.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $81.28 | Professional | None | $43.65 | $54.95 | $81.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $43.65 Median $50.12 Typical High $91.20 | Facility | None | $43.65 | $50.12 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $190.55 | Facility | None | $56.23 | $91.20 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $53.70 | Professional | None | $43.65 | $43.65 | $53.70 |
Fallon Health Setting Facility Modifier None Typical Low $43.65 Median $57.54 Typical High $83.18 | Facility | None | $43.65 | $57.54 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $91.20 | Professional | None | $43.65 | $54.95 | $91.20 |
Mass General Brigham Setting Facility Modifier None Typical Low $77.62 Median $109.65 Typical High $144.54 | Facility | None | $77.62 | $109.65 | $144.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $81.28 | Professional | None | $43.65 | $54.95 | $81.28 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $91.20 | Professional | None | $54.95 | $54.95 | $91.20 |
Well Sense Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $107.15 | Facility | None | $54.95 | $66.07 | $107.15 |
Well Sense Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | None | $43.65 | $43.65 | $52.48 |
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 $21.88 Median $21.88 Typical High $22.91 | Professional | 52 · Reduced service | $21.88 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | 53 · Discontinued | $8.71 | $8.71 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.57 |
Where Massachusetts sits
The same service costs 2.0 times more in Alaska than in Wyoming. 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· 16th of 51
$54.95
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.