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 $436.52 Median $436.52 Typical High $467.74 | Facility | None | $436.52 | $436.52 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | None | $467.74 | $467.74 | $489.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $1,174.90 Typical High $1,513.56 | Facility | None | $371.54 | $1,174.90 | $1,513.56 |
AllWays Health Partners Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $912.01 | Professional | None | $467.74 | $501.19 | $912.01 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $467.74 Median $537.03 Typical High $954.99 | Facility | None | $467.74 | $537.03 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $831.76 Typical High $2,041.74 | Facility | None | $467.74 | $831.76 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $575.44 | Professional | None | $467.74 | $467.74 | $575.44 |
Fallon Health Setting Facility Modifier None Typical Low $467.74 Median $616.60 Typical High $741.31 | Facility | None | $467.74 | $616.60 | $741.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $933.25 | Professional | None | $467.74 | $467.74 | $933.25 |
Health New England Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $1,174.90 Typical High $1,513.56 | Facility | None | $371.54 | $1,174.90 | $1,513.56 |
Mass General Brigham Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $912.01 | Professional | None | $467.74 | $501.19 | $912.01 |
United Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
United Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $1,445.44 | Professional | None | $467.74 | $501.19 | $1,445.44 |
Well Sense Setting Facility Modifier None Typical Low $512.86 Median $645.65 Typical High $1,096.48 | Facility | None | $512.86 | $645.65 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | None | $467.74 | $467.74 | $562.34 |
2 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 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Where Massachusetts sits
The same service costs 3.9 times more in Alabama than in Oklahoma. 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· 23rd of 51
$501
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.