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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $208.93 | Facility | None | $63.10 | $63.10 | $208.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $120.23 | Professional | None | $63.10 | $81.28 | $120.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $70.79 Median $81.28 Typical High $147.91 | Facility | None | $70.79 | $81.28 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $83.18 | Facility | None | $56.23 | $83.18 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $138.04 | Professional | None | $70.79 | $81.28 | $138.04 |
Mass General Brigham Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $208.93 | Facility | None | $63.10 | $63.10 | $208.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $120.23 | Professional | None | $63.10 | $81.28 | $120.23 |
United Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $138.04 | Professional | None | $69.18 | $81.28 | $138.04 |
5 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 $34.67 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Well Sense Setting Facility Modifier 52 · Reduced service Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Where Massachusetts sits
The same service costs 1.9 times more in Alabama than in New York. 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· 14th of 51
$81.28
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.