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 $208.93 Median $208.93 Typical High $288.40 | Facility | None | $208.93 | $208.93 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $288.40 | Professional | None | $208.93 | $208.93 | $288.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $208.93 Median $524.81 Typical High $676.08 | Facility | None | $208.93 | $524.81 | $676.08 |
AllWays Health Partners Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $281.84 | Professional | None | $186.21 | $208.93 | $281.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $426.58 | Facility | None | $208.93 | $234.42 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $371.54 Typical High $912.01 | Facility | None | $199.53 | $371.54 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | None | $208.93 | $208.93 | $269.15 |
Fallon Health Setting Facility Modifier None Typical Low $186.21 Median $263.03 Typical High $302.00 | Facility | None | $186.21 | $263.03 | $302.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $186.21 Median $194.98 Typical High $389.05 | Professional | None | $186.21 | $194.98 | $389.05 |
Mass General Brigham Setting Facility Modifier None Typical Low $208.93 Median $524.81 Typical High $676.08 | Facility | None | $208.93 | $524.81 | $676.08 |
Mass General Brigham Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $281.84 | Professional | None | $186.21 | $208.93 | $281.84 |
Tufts Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $588.84 | Professional | None | $186.21 | $199.53 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $288.40 Typical High $489.78 | Facility | None | $208.93 | $288.40 | $489.78 |
Well Sense Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | None | $208.93 | $208.93 | $251.19 |
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 $104.71 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 53 · Discontinued | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $21.88 |
Where Massachusetts sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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
$209
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.