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 $31.62 Median $31.62 Typical High $54.95 | Facility | None | $31.62 | $31.62 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $40.74 | Professional | None | $31.62 | $31.62 | $40.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $16.22 Median $31.62 Typical High $104.71 | Facility | None | $16.22 | $31.62 | $104.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | None | $31.62 | $31.62 | $57.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $31.62 Median $36.31 Typical High $66.07 | Facility | None | $31.62 | $36.31 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $66.07 Typical High $138.04 | Facility | None | $40.74 | $66.07 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $70.79 | Professional | None | $31.62 | $31.62 | $70.79 |
Fallon Health Setting Facility Modifier None Typical Low $31.62 Median $43.65 Typical High $63.10 | Facility | None | $31.62 | $43.65 | $63.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | None | $31.62 | $31.62 | $57.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $16.22 Median $31.62 Typical High $104.71 | Facility | None | $16.22 | $31.62 | $104.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | None | $31.62 | $31.62 | $57.54 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | None | $31.62 | $31.62 | $57.54 |
Well Sense Setting Facility Modifier None Typical Low $34.67 Median $44.67 Typical High $74.13 | Facility | None | $34.67 | $44.67 | $74.13 |
Well Sense Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | None | $31.62 | $31.62 | $38.02 |
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 $15.85 Median $15.85 Typical High $16.60 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.61 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.90 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.31 |
Where Massachusetts sits
The same service costs 3.8 times more in Alabama than in Virginia. 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· 25th of 51
$32.36
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.