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 $117.49 Median $117.49 Typical High $213.80 | Facility | None | $117.49 | $117.49 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | None | $117.49 | $117.49 | $134.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $169.82 Median $295.12 Typical High $380.19 | Facility | None | $169.82 | $295.12 | $380.19 |
AllWays Health Partners Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $288.40 | Professional | None | $117.49 | $147.91 | $288.40 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $117.49 Median $134.90 Typical High $239.88 | Facility | None | $117.49 | $134.90 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $512.86 | Facility | None | $151.36 | $245.47 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $239.88 | Professional | None | $117.49 | $117.49 | $239.88 |
Fallon Health Setting Facility Modifier None Typical Low $117.49 Median $165.96 Typical High $208.93 | Facility | None | $117.49 | $165.96 | $208.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $316.23 | Professional | None | $117.49 | $147.91 | $316.23 |
Health New England Setting Facility Modifier None Typical Low $223.87 Median $275.42 Typical High $891.25 | Facility | None | $223.87 | $275.42 | $891.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $169.82 Median $295.12 Typical High $380.19 | Facility | None | $169.82 | $295.12 | $380.19 |
Mass General Brigham Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $288.40 | Professional | None | $117.49 | $147.91 | $288.40 |
Tufts Setting Facility Modifier None Typical Low $162.18 Median $194.98 Typical High $416.87 | Facility | None | $162.18 | $194.98 | $416.87 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $288.40 | Professional | None | $147.91 | $147.91 | $288.40 |
Well Sense Setting Facility Modifier None Typical Low $147.91 Median $177.83 Typical High $288.40 | Facility | None | $147.91 | $177.83 | $288.40 |
Well Sense Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | None | $117.49 | $117.49 | $141.25 |
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 $58.88 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $23.44 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $18.20 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.30 |
Where Massachusetts sits
The same service costs 2.0 times more in Kansas 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· 37th of 51
$148
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.