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 $17.78 Median $17.78 Typical High $53.70 | Facility | None | $17.78 | $17.78 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2.75 Median $17.78 Typical High $169.82 | Facility | None | $2.75 | $17.78 | $169.82 |
AllWays Health Partners Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $77.62 | Professional | None | $51.29 | $52.48 | $77.62 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $53.70 Median $61.66 Typical High $112.20 | Facility | None | $53.70 | $61.66 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $112.20 Typical High $234.42 | Facility | None | $69.18 | $112.20 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $53.70 | Professional | None | $47.86 | $53.70 | $53.70 |
Fallon Health Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $83.18 | Facility | None | $53.70 | $70.79 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $89.13 | Professional | None | $51.29 | $53.70 | $89.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $2.75 Median $17.78 Typical High $169.82 | Facility | None | $2.75 | $17.78 | $169.82 |
Mass General Brigham Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $77.62 | Professional | None | $51.29 | $52.48 | $77.62 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $87.10 | Professional | None | $51.29 | $51.29 | $87.10 |
Well Sense Setting Facility Modifier None Typical Low $57.54 Median $75.86 Typical High $125.89 | Facility | None | $57.54 | $75.86 | $125.89 |
Well Sense Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | None | $53.70 | $53.70 | $64.57 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where Massachusetts sits
The same service costs 3.0 times more in Arizona than in Oklahoma. 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· 30th of 51
$53.70
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.