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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $10.23 Median $29.51 Typical High $33.11 | Facility | None | $10.23 | $29.51 | $33.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $10.23 Median $36.31 Typical High $67.61 | Professional | None | $10.23 | $36.31 | $67.61 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $41.69 Median $47.86 Typical High $87.10 | Facility | None | $41.69 | $47.86 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $77.62 Typical High $162.18 | Facility | None | $47.86 | $77.62 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $64.57 | Professional | None | $37.15 | $37.15 | $64.57 |
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 $36.31 Median $37.15 Typical High $83.18 | Professional | None | $36.31 | $37.15 | $83.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $10.23 Median $29.51 Typical High $33.11 | Facility | None | $10.23 | $29.51 | $33.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $10.23 Median $36.31 Typical High $67.61 | Professional | None | $10.23 | $36.31 | $67.61 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $67.61 | Professional | None | $36.31 | $36.31 | $67.61 |
Well Sense Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $77.62 | Facility | None | $43.65 | $51.29 | $77.62 |
Well Sense Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | None | $37.15 | $37.15 | $44.67 |
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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
Where Massachusetts sits
The same service costs 8.1 times more in Kansas 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· 36th of 51
$37.15
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.