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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
AllWays Health Partners Setting Facility Modifier None Typical Low $208.93 Median $275.42 Typical High $691.83 | Facility | None | $208.93 | $275.42 | $691.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $194.98 | Professional | None | $83.18 | $128.82 | $194.98 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $112.20 Median $128.82 Typical High $229.09 | Facility | None | $112.20 | $128.82 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $112.20 Median $128.82 Typical High $218.78 | Professional | None | $112.20 | $128.82 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $208.93 Median $275.42 Typical High $691.83 | Facility | None | $208.93 | $275.42 | $691.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $194.98 | Professional | None | $83.18 | $128.82 | $194.98 |
United Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $218.78 | Professional | None | $109.65 | $128.82 | $218.78 |
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 $54.95 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $10.96 |
Well Sense Setting Facility Modifier 52 · Reduced service Typical Low $691.83 Median $870.96 Typical High $933.25 | Facility | 52 · Reduced service | $691.83 | $870.96 | $933.25 |
Where Massachusetts sits
The same service costs 3.7 times more in Alaska than in Arkansas. 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· 9th of 51
$129
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.