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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
AllWays Health Partners Setting Facility Modifier None Typical Low $22.91 Median $87.10 Typical High $245.47 | Facility | None | $22.91 | $87.10 | $245.47 |
AllWays Health Partners Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $158.49 | Professional | None | $46.77 | $66.07 | $158.49 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $162.18 | Facility | None | $77.62 | $89.13 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $338.84 | Facility | None | $100.00 | $162.18 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $77.62 | Professional | None | $50.12 | $77.62 | $77.62 |
Fallon Health Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $117.49 | Facility | None | $77.62 | $100.00 | $117.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $158.49 | Professional | None | $46.77 | $77.62 | $158.49 |
Mass General Brigham Setting Facility Modifier None Typical Low $22.91 Median $87.10 Typical High $245.47 | Facility | None | $22.91 | $87.10 | $245.47 |
Mass General Brigham Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $158.49 | Professional | None | $46.77 | $66.07 | $158.49 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $158.49 | Professional | None | $46.77 | $46.77 | $158.49 |
Well Sense Setting Facility Modifier None Typical Low $51.29 Median $100.00 Typical High $181.97 | Facility | None | $51.29 | $100.00 | $181.97 |
Well Sense Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | None | $77.62 | $77.62 | $93.33 |
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 $38.90 Median $38.90 Typical High $40.74 | Professional | 52 · Reduced service | $38.90 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $16.22 | Professional | 53 · Discontinued | $15.49 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $12.02 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $8.13 |
Where Massachusetts sits
The same service costs 3.6 times more in Texas than in Kansas. 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· 31st of 51
$77.62
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.