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 $54.95 Median $54.95 Typical High $56.23 | Facility | None | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | None | $54.95 | $54.95 | $60.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $26.92 Median $162.18 Typical High $173.78 | Facility | None | $26.92 | $162.18 | $173.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $85.11 | Professional | None | $54.95 | $54.95 | $85.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $54.95 Median $63.10 Typical High $112.20 | Facility | None | $54.95 | $63.10 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $239.88 | Facility | None | $70.79 | $114.82 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | None | $54.95 | $54.95 | $60.26 |
Fallon Health Setting Facility Modifier None Typical Low $54.95 Median $72.44 Typical High $83.18 | Facility | None | $54.95 | $72.44 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $93.33 | Professional | None | $54.95 | $54.95 | $93.33 |
Health New England Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $26.92 Median $162.18 Typical High $173.78 | Facility | None | $26.92 | $162.18 | $173.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $85.11 | Professional | None | $54.95 | $54.95 | $85.11 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $93.33 | Professional | None | $54.95 | $54.95 | $93.33 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $77.62 Typical High $128.82 | Facility | None | $60.26 | $77.62 | $128.82 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | None | $54.95 | $54.95 | $66.07 |
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 $27.54 Median $27.54 Typical High $28.18 | Professional | 52 · Reduced service | $27.54 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 53 · Discontinued | $10.96 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.62 |
Where Massachusetts sits
The same service costs 2.7 times more in Oklahoma than in West Virginia. 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· 33rd of 51
$56.23
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.