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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $234.42 | Facility | None | $95.50 | $100.00 | $234.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $177.83 | Professional | None | $91.20 | $120.23 | $177.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $134.90 Median $154.88 Typical High $281.84 | Facility | None | $134.90 | $154.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $524.81 | Facility | None | $158.49 | $257.04 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | None | $123.03 | $123.03 | $141.25 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $158.49 Typical High $181.97 | Facility | None | $83.18 | $158.49 | $181.97 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $204.17 | Professional | None | $120.23 | $123.03 | $204.17 |
Mass General Brigham Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $234.42 | Facility | None | $95.50 | $100.00 | $234.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $177.83 | Professional | None | $91.20 | $120.23 | $177.83 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | None | $120.23 | $120.23 | $204.17 |
Well Sense Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $288.40 | Facility | None | $134.90 | $181.97 | $288.40 |
Well Sense Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | None | $123.03 | $123.03 | $147.91 |
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 $61.66 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
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 $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Where Massachusetts sits
The same service costs 1.7 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· 26th of 51
$123
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.