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 $31.62 Median $31.62 Typical High $123.03 | Facility | None | $31.62 | $31.62 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | None | $31.62 | $31.62 | $32.36 |
AllWays Health Partners Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $109.65 | Facility | None | $67.61 | $87.10 | $109.65 |
AllWays Health Partners Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $69.18 | Professional | None | $31.62 | $33.88 | $69.18 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $31.62 Median $35.48 Typical High $64.57 | Facility | None | $31.62 | $35.48 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $66.07 Typical High $138.04 | Facility | None | $40.74 | $66.07 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $45.71 | Professional | None | $31.62 | $31.62 | $45.71 |
Fallon Health Setting Facility Modifier None Typical Low $31.62 Median $42.66 Typical High $63.10 | Facility | None | $31.62 | $42.66 | $63.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $69.18 | Professional | None | $31.62 | $33.88 | $69.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $109.65 | Facility | None | $67.61 | $87.10 | $109.65 |
Mass General Brigham Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $69.18 | Professional | None | $31.62 | $33.88 | $69.18 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $69.18 | Professional | None | $33.88 | $33.88 | $69.18 |
Well Sense Setting Facility Modifier None Typical Low $37.15 Median $46.77 Typical High $72.44 | Facility | None | $37.15 | $46.77 | $72.44 |
Well Sense Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | None | $31.62 | $31.62 | $38.02 |
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 $15.85 Median $15.85 Typical High $16.22 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.61 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.90 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.24 |
Where Massachusetts sits
The same service costs 2.3 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· 21st of 51
$36.31
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.