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 $64.57 Median $64.57 Typical High $151.36 | Facility | None | $64.57 | $64.57 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Professional | None | $64.57 | $64.57 | $72.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $79.43 Median $107.15 Typical High $208.93 | Facility | None | $79.43 | $107.15 | $208.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $151.36 | Professional | None | $63.10 | $64.57 | $151.36 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $72.44 Median $81.28 Typical High $147.91 | Facility | None | $72.44 | $81.28 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $223.87 | Facility | None | $66.07 | $107.15 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $79.43 | Professional | None | $51.29 | $51.29 | $79.43 |
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 $63.10 Median $64.57 Typical High $151.36 | Professional | None | $63.10 | $64.57 | $151.36 |
Health New England Setting Facility Modifier None Typical Low $5.75 Median $70.79 Typical High $75.86 | Facility | None | $5.75 | $70.79 | $75.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $79.43 Median $107.15 Typical High $208.93 | Facility | None | $79.43 | $107.15 | $208.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $151.36 | Professional | None | $63.10 | $64.57 | $151.36 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $151.36 | Professional | None | $63.10 | $63.10 | $151.36 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $70.79 Typical High $104.71 | Facility | None | $60.26 | $70.79 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | None | $51.29 | $51.29 | $61.66 |
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 $32.36 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.46 |
Where Massachusetts sits
The same service costs 3.0 times more in Kansas than in South Carolina. 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· 6th of 51
$67.61
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.