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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,047.13 Median $2,630.27 Typical High $3,388.44 | Facility | None | $1,047.13 | $2,630.27 | $3,388.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,174.90 | $1,778.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,137.96 | Facility | None | $1,047.13 | $1,202.26 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $4,570.88 | Facility | None | $1,348.96 | $2,187.76 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,047.13 | $1,288.25 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $8,511.38 | Facility | None | $83.18 | $3,630.78 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,174.90 | $1,995.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,047.13 Median $2,630.27 Typical High $3,388.44 | Facility | None | $1,047.13 | $2,630.27 | $3,388.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,174.90 | $1,778.28 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,174.90 | $1,995.26 |
Well Sense Setting Facility Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $5,754.40 | Facility | None | $3,090.30 | $3,801.89 | $5,754.40 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Where Massachusetts sits
The same service costs 5.8 times more in Alabama than in Arkansas. 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· 20th of 51
$1,175
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.