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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $467.74 Median $562.34 Typical High $1,659.59 | Facility | None | $467.74 | $562.34 | $1,659.59 |
AllWays Health Partners Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $741.31 | Professional | None | $489.78 | $501.19 | $741.31 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $512.86 Median $575.44 Typical High $1,047.13 | Facility | None | $512.86 | $575.44 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,071.52 Typical High $2,238.72 | Facility | None | $660.69 | $1,071.52 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | None | $512.86 | $512.86 | $602.56 |
Fallon Health Setting Facility Modifier None Typical Low $501.19 Median $660.69 Typical High $1,000.00 | Facility | None | $501.19 | $660.69 | $1,000.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $831.76 | Professional | None | $501.19 | $512.86 | $831.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $467.74 Median $562.34 Typical High $1,659.59 | Facility | None | $467.74 | $562.34 | $1,659.59 |
Mass General Brigham Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $741.31 | Professional | None | $489.78 | $501.19 | $741.31 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $831.76 | Professional | None | $489.78 | $501.19 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $1,174.90 | Facility | None | $549.54 | $741.31 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | None | $512.86 | $512.86 | $616.60 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Where Massachusetts sits
The same service costs 2.8 times more in Arizona than in Oklahoma. 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
$513
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.