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 $26.30 Median $26.30 Typical High $54.95 | Facility | None | $26.30 | $26.30 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $16.98 Median $54.95 Typical High $173.78 | Facility | None | $16.98 | $54.95 | $173.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $81.28 | Professional | None | $53.70 | $54.95 | $81.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $61.66 Median $70.79 Typical High $125.89 | Facility | None | $61.66 | $70.79 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $239.88 | Facility | None | $70.79 | $114.82 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $69.18 | Professional | None | $54.95 | $54.95 | $69.18 |
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 $35.48 Median $53.70 Typical High $81.28 | Professional | None | $35.48 | $53.70 | $81.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $16.98 Median $54.95 Typical High $173.78 | Facility | None | $16.98 | $54.95 | $173.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $81.28 | Professional | None | $53.70 | $54.95 | $81.28 |
United Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $91.20 | Professional | None | $53.70 | $53.70 | $91.20 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $75.86 Typical High $112.20 | Facility | None | $64.57 | $75.86 | $112.20 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | None | $54.95 | $54.95 | $66.07 |
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 $27.54 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Where Massachusetts sits
The same service costs 2.2 times more in Alaska 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· 16th of 51
$54.95
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.