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 $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $537.03 Median $588.84 Typical High $1,778.28 | Facility | None | $537.03 | $588.84 | $1,778.28 |
AllWays Health Partners Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $758.58 | Professional | None | $512.86 | $524.81 | $758.58 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $575.44 Median $660.69 Typical High $1,202.26 | Facility | None | $575.44 | $660.69 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $2,238.72 | Facility | None | $676.08 | $1,096.48 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $645.65 | Professional | None | $524.81 | $524.81 | $645.65 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $707.95 Typical High $2,951.21 | Facility | None | $83.18 | $707.95 | $2,951.21 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $870.96 | Professional | None | $512.86 | $524.81 | $870.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $537.03 Median $588.84 Typical High $1,778.28 | Facility | None | $537.03 | $588.84 | $1,778.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $758.58 | Professional | None | $512.86 | $524.81 | $758.58 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $870.96 | Professional | None | $512.86 | $512.86 | $870.96 |
Well Sense Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $1,071.52 | Facility | None | $524.81 | $724.44 | $1,071.52 |
Well Sense Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | None | $524.81 | $524.81 | $630.96 |
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 $263.03 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in Hawaii. 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· 10th of 51
$537
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.