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 $501.19 Median $501.19 Typical High $1,096.48 | Facility | None | $501.19 | $501.19 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $147.91 Median $891.25 Typical High $1,174.90 | Facility | None | $147.91 | $891.25 | $1,174.90 |
AllWays Health Partners Setting Professional Modifier None Typical Low $147.91 Median $1,071.52 Typical High $1,621.81 | Professional | None | $147.91 | $1,071.52 | $1,621.81 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,380.38 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,290.87 Typical High $4,786.30 | Facility | None | $1,412.54 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,096.48 | $1,202.26 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $8,511.38 | Facility | None | $83.18 | $3,630.78 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $1,318.26 | Professional | None | $407.38 | $630.96 | $1,318.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $147.91 Median $891.25 Typical High $1,174.90 | Facility | None | $147.91 | $891.25 | $1,174.90 |
Mass General Brigham Setting Professional Modifier None Typical Low $147.91 Median $1,071.52 Typical High $1,621.81 | Professional | None | $147.91 | $1,071.52 | $1,621.81 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,071.52 | $1,819.70 |
Well Sense Setting Facility Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,238.72 | Facility | None | $1,288.25 | $1,513.56 | $2,238.72 |
Well Sense Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,096.48 | $1,318.26 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Where Massachusetts sits
The same service costs 8.3 times more in Arizona than in Montana. 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· 15th of 51
$1,096
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.