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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | None | $61.66 | $61.66 | $70.79 |
AllWays Health Partners Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $199.53 | Facility | None | $60.26 | $67.61 | $199.53 |
AllWays Health Partners Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $89.13 | Professional | None | $60.26 | $61.66 | $89.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $125.89 | Facility | None | $61.66 | $69.18 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $128.82 Typical High $263.03 | Facility | None | $79.43 | $128.82 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | None | $61.66 | $61.66 | $74.13 |
Fallon Health Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $89.13 | Facility | None | $61.66 | $79.43 | $89.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $100.00 | Professional | None | $60.26 | $61.66 | $100.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $199.53 | Facility | None | $60.26 | $67.61 | $199.53 |
Mass General Brigham Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $89.13 | Professional | None | $60.26 | $61.66 | $89.13 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $100.00 | Professional | None | $60.26 | $60.26 | $100.00 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $79.43 Typical High $117.49 | Facility | None | $60.26 | $79.43 | $117.49 |
Well Sense Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | None | $61.66 | $61.66 | $72.44 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
Where Massachusetts sits
The same service costs 1.9 times more in Alaska 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· 27th of 51
$61.66
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.