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 $41.69 Median $41.69 Typical High $72.44 | Facility | None | $41.69 | $41.69 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | None | $41.69 | $41.69 | $43.65 |
AllWays Health Partners Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $158.49 | Facility | None | $104.71 | $134.90 | $158.49 |
AllWays Health Partners Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $186.21 | Professional | None | $41.69 | $52.48 | $186.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $41.69 Median $46.77 Typical High $85.11 | Facility | None | $41.69 | $46.77 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $74.13 Typical High $181.97 | Facility | None | $53.70 | $74.13 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $109.65 | Professional | None | $41.69 | $41.69 | $109.65 |
Fallon Health Setting Facility Modifier None Typical Low $41.69 Median $60.26 Typical High $79.43 | Facility | None | $41.69 | $60.26 | $79.43 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $186.21 | Professional | None | $41.69 | $50.12 | $186.21 |
Mass General Brigham Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $158.49 | Facility | None | $104.71 | $134.90 | $158.49 |
Mass General Brigham Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $186.21 | Professional | None | $41.69 | $52.48 | $186.21 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $186.21 | Professional | None | $50.12 | $52.48 | $186.21 |
Well Sense Setting Facility Modifier None Typical Low $51.29 Median $63.10 Typical High $97.72 | Facility | None | $51.29 | $63.10 | $97.72 |
Well Sense Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | None | $41.69 | $41.69 | $50.12 |
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 $20.89 Median $20.89 Typical High $21.38 | Professional | 52 · Reduced service | $20.89 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.71 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.46 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.27 |
Where Massachusetts sits
The same service costs 3.9 times more in Wyoming than in Georgia. 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· 23rd of 51
$52.48
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.