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 $131.83 Median $131.83 Typical High $812.83 | Facility | None | $131.83 | $131.83 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $79.43 Median $1,778.28 Typical High $3,630.78 | Facility | None | $79.43 | $1,778.28 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,348.96 | Professional | None | $794.33 | $1,122.02 | $1,348.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,862.09 | Facility | None | $912.01 | $1,047.13 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $3,548.13 | Facility | None | $1,047.13 | $1,698.24 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,445.44 | Professional | None | $812.83 | $812.83 | $1,445.44 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $7,079.46 | Facility | None | $83.18 | $3,630.78 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $3,715.35 | Professional | None | $794.33 | $1,148.15 | $3,715.35 |
Mass General Brigham Setting Facility Modifier None Typical Low $79.43 Median $1,778.28 Typical High $3,630.78 | Facility | None | $79.43 | $1,778.28 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,348.96 | Professional | None | $794.33 | $1,122.02 | $1,348.96 |
United Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,348.96 | Professional | None | $794.33 | $794.33 | $1,348.96 |
Well Sense Setting Facility Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,659.59 | Facility | None | $954.99 | $1,122.02 | $1,659.59 |
Well Sense Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Where Massachusetts sits
The same service costs 2.6 times more in Alabama than in Florida. 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· 15th of 51
$1,096
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.