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 $89.13 Median $89.13 Typical High $234.42 | Facility | None | $89.13 | $89.13 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $141.25 | Facility | None | $66.07 | $87.10 | $141.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $26.30 Median $87.10 Typical High $128.82 | Professional | None | $26.30 | $87.10 | $128.82 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $97.72 Median $112.20 Typical High $204.17 | Facility | None | $97.72 | $112.20 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $380.19 | Facility | None | $114.82 | $186.21 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | None | $89.13 | $89.13 | $109.65 |
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 $87.10 Median $91.20 Typical High $147.91 | Professional | None | $87.10 | $91.20 | $147.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $141.25 | Facility | None | $66.07 | $87.10 | $141.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $26.30 Median $87.10 Typical High $128.82 | Professional | None | $26.30 | $87.10 | $128.82 |
United Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $147.91 | Professional | None | $87.10 | $87.10 | $147.91 |
Well Sense Setting Facility Modifier None Typical Low $89.13 Median $123.03 Typical High $181.97 | Facility | None | $89.13 | $123.03 | $181.97 |
Well Sense Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | None | $89.13 | $89.13 | $107.15 |
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 $44.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $8.91 |
Where Massachusetts sits
The same service costs 1.6 times more in Alaska than in Texas. 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· 12th of 51
$91.20
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.