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 $13.18 Median $13.18 Typical High $295.12 | Facility | None | $13.18 | $13.18 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.02 Median $58.88 Typical High $933.25 | Facility | None | $3.02 | $58.88 | $933.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $380.19 | Professional | None | $213.80 | $295.12 | $380.19 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $295.12 Median $338.84 Typical High $616.60 | Facility | None | $295.12 | $338.84 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $1,288.25 | Facility | None | $380.19 | $616.60 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $676.08 | Professional | None | $295.12 | $295.12 | $676.08 |
Fallon Health Setting Facility Modifier None Typical Low $213.80 Median $302.00 Typical High $446.68 | Facility | None | $213.80 | $302.00 | $446.68 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $489.78 | Professional | None | $213.80 | $295.12 | $489.78 |
Health New England Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $676.08 | Facility | None | $489.78 | $489.78 | $676.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.02 Median $58.88 Typical High $933.25 | Facility | None | $3.02 | $58.88 | $933.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $380.19 | Professional | None | $213.80 | $295.12 | $380.19 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $380.19 | Professional | None | $213.80 | $213.80 | $380.19 |
Well Sense Setting Facility Modifier None Typical Low $234.42 Median $389.05 Typical High $691.83 | Facility | None | $234.42 | $389.05 | $691.83 |
Well Sense Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | None | $295.12 | $295.12 | $354.81 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
Where Massachusetts sits
The same service costs 6.8 times more in Wyoming 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· 17th of 51
$295
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.