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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | None | $128.82 | $128.82 | $147.91 |
AllWays Health Partners Setting Facility Modifier None Typical Low $125.89 Median $144.54 Typical High $426.58 | Facility | None | $125.89 | $144.54 | $426.58 |
AllWays Health Partners Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $194.98 | Professional | None | $125.89 | $128.82 | $194.98 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $269.15 | Facility | None | $128.82 | $147.91 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $234.42 Typical High $562.34 | Facility | None | $154.88 | $234.42 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | None | $128.82 | $128.82 | $158.49 |
Fallon Health Setting Facility Modifier None Typical Low $128.82 Median $169.82 Typical High $194.98 | Facility | None | $128.82 | $169.82 | $194.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $218.78 | Professional | None | $128.82 | $128.82 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $125.89 Median $144.54 Typical High $426.58 | Facility | None | $125.89 | $144.54 | $426.58 |
Mass General Brigham Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $194.98 | Professional | None | $125.89 | $128.82 | $194.98 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $218.78 | Professional | None | $125.89 | $128.82 | $218.78 |
Well Sense Setting Facility Modifier None Typical Low $128.82 Median $177.83 Typical High $269.15 | Facility | None | $128.82 | $177.83 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | None | $128.82 | $128.82 | $154.88 |
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 $64.57 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $12.88 |
Where Massachusetts sits
The same service costs 1.6 times more in Texas than in North Carolina. 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· 37th of 51
$129
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.