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 $389.05 Median $389.05 Typical High $478.63 | Facility | None | $389.05 | $389.05 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
AllWays Health Partners Setting Facility Modifier None Typical Low $288.40 Median $489.78 Typical High $489.78 | Facility | None | $288.40 | $489.78 | $489.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $691.83 | Professional | None | $467.74 | $478.63 | $691.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $489.78 Median $562.34 Typical High $1,023.29 | Facility | None | $489.78 | $562.34 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $2,041.74 | Facility | None | $616.60 | $1,000.00 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $588.84 | Professional | None | $478.63 | $478.63 | $588.84 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $3,630.78 | Facility | None | $56.23 | $83.18 | $3,630.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $794.33 | Professional | None | $467.74 | $489.78 | $794.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $288.40 Median $489.78 Typical High $489.78 | Facility | None | $288.40 | $489.78 | $489.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $691.83 | Professional | None | $467.74 | $478.63 | $691.83 |
United Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $794.33 | Professional | None | $467.74 | $467.74 | $794.33 |
Well Sense Setting Facility Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $4,265.80 | Facility | None | $3,090.30 | $3,630.78 | $4,265.80 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $239.88 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
Where Massachusetts sits
The same service costs 2.3 times more in Arizona than in Idaho. 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· 14th of 51
$490
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.