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 $138.04 Median $138.04 Typical High $162.18 | Facility | None | $138.04 | $138.04 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
AllWays Health Partners Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $269.15 | Professional | None | $141.25 | $158.49 | $269.15 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $380.19 | Facility | None | $181.97 | $208.93 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $707.95 | Facility | None | $208.93 | $338.84 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | None | $162.18 | $162.18 | $190.55 |
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 $158.49 Median $162.18 Typical High $269.15 | Professional | None | $158.49 | $162.18 | $269.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $269.15 | Professional | None | $141.25 | $158.49 | $269.15 |
United Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $269.15 | Professional | None | $141.25 | $158.49 | $269.15 |
Well Sense Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $338.84 | Facility | None | $190.55 | $223.87 | $338.84 |
Well Sense Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | None | $162.18 | $162.18 | $194.98 |
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 $81.28 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.22 |
Where Massachusetts sits
The same service costs 4.4 times more in Alaska 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
$162
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.