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 $19.50 Median $19.50 Typical High $104.71 | Facility | None | $19.50 | $19.50 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $6.03 Median $107.15 Typical High $141.25 | Facility | None | $6.03 | $107.15 | $141.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $181.97 | Professional | None | $104.71 | $123.03 | $181.97 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $107.15 Median $123.03 Typical High $223.87 | Facility | None | $107.15 | $123.03 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $467.74 | Facility | None | $141.25 | $229.09 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | None | $107.15 | $107.15 | $134.90 |
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 $107.15 Median $123.03 Typical High $208.93 | Professional | None | $107.15 | $123.03 | $208.93 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.03 Median $107.15 Typical High $141.25 | Facility | None | $6.03 | $107.15 | $141.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $181.97 | Professional | None | $104.71 | $123.03 | $181.97 |
United Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $208.93 | Professional | None | $104.71 | $123.03 | $208.93 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Where Massachusetts sits
The same service costs 3.9 times more in Alaska than in Montana. 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· 17th of 51
$123
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.