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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $128.82 Median $316.23 Typical High $416.87 | Facility | None | $128.82 | $316.23 | $416.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $186.21 | Professional | None | $125.89 | $128.82 | $186.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $141.25 Median $162.18 Typical High $295.12 | Facility | None | $141.25 | $162.18 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $269.15 Typical High $549.54 | Facility | None | $165.96 | $269.15 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | None | $128.82 | $128.82 | $158.49 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $169.82 Typical High $194.98 | Facility | None | $83.18 | $169.82 | $194.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $213.80 | Professional | None | $125.89 | $128.82 | $213.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $128.82 Median $316.23 Typical High $416.87 | Facility | None | $128.82 | $316.23 | $416.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $186.21 | Professional | None | $125.89 | $128.82 | $186.21 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $213.80 | Professional | None | $125.89 | $125.89 | $213.80 |
Well Sense Setting Facility Modifier None Typical Low $128.82 Median $177.83 Typical High $263.03 | Facility | None | $128.82 | $177.83 | $263.03 |
Well Sense Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | None | $128.82 | $128.82 | $151.36 |
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 $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $12.88 |
Where Massachusetts sits
The same service costs 2.3 times more in Texas 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· 29th of 51
$129
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.