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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $41.69 Median $46.77 Typical High $138.04 | Facility | None | $41.69 | $46.77 | $138.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $61.66 | Professional | None | $40.74 | $42.66 | $61.66 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $42.66 Median $48.98 Typical High $87.10 | Facility | None | $42.66 | $48.98 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $89.13 Typical High $186.21 | Facility | None | $54.95 | $89.13 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $52.48 | Professional | None | $42.66 | $42.66 | $52.48 |
Fallon Health Setting Facility Modifier None Typical Low $42.66 Median $56.23 Typical High $66.07 | Facility | None | $42.66 | $56.23 | $66.07 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $69.18 | Professional | None | $40.74 | $42.66 | $69.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $41.69 Median $46.77 Typical High $138.04 | Facility | None | $41.69 | $46.77 | $138.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $61.66 | Professional | None | $40.74 | $42.66 | $61.66 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $69.18 | Professional | None | $40.74 | $40.74 | $69.18 |
Well Sense Setting Facility Modifier None Typical Low $44.67 Median $63.10 Typical High $100.00 | Facility | None | $44.67 | $63.10 | $100.00 |
Well Sense Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $51.29 | Professional | None | $42.66 | $42.66 | $51.29 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in Maryland. 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· 32nd of 51
$42.66
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.