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 $223.87 Median $223.87 Typical High $398.11 | Facility | None | $223.87 | $223.87 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2.75 Median $354.81 Typical High $1,258.93 | Facility | None | $2.75 | $354.81 | $1,258.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $588.84 | Professional | None | $389.05 | $398.11 | $588.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $398.11 Median $457.09 Typical High $831.76 | Facility | None | $398.11 | $457.09 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $1,737.80 | Facility | None | $512.86 | $851.14 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | None | $398.11 | $398.11 | $478.63 |
Fallon Health Setting Facility Modifier None Typical Low $389.05 Median $524.81 Typical High $616.60 | Facility | None | $389.05 | $524.81 | $616.60 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $660.69 | Professional | None | $389.05 | $398.11 | $660.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $2.75 Median $354.81 Typical High $1,258.93 | Facility | None | $2.75 | $354.81 | $1,258.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $588.84 | Professional | None | $389.05 | $398.11 | $588.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $660.69 | Professional | None | $389.05 | $389.05 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $426.58 Median $562.34 Typical High $933.25 | Facility | None | $426.58 | $562.34 | $933.25 |
Well Sense Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | None | $398.11 | $398.11 | $478.63 |
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 $199.53 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $39.81 |
Where Massachusetts sits
The same service costs 2.8 times more in Arizona than in Alabama. 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· 29th of 51
$398
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.