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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | None | $537.03 | $537.03 | $562.34 |
AllWays Health Partners Setting Facility Modifier None Typical Low $489.78 Median $588.84 Typical High $1,737.80 | Facility | None | $489.78 | $588.84 | $1,737.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $1,174.90 | Professional | None | $524.81 | $537.03 | $1,174.90 |
BCBS Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $1,096.48 | Facility | None | $537.03 | $602.56 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $2,290.87 | Facility | None | $691.83 | $1,122.02 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $660.69 | Professional | None | $537.03 | $537.03 | $660.69 |
Fallon Health Setting Facility Modifier None Typical Low $537.03 Median $741.31 Typical High $5,888.44 | Facility | None | $537.03 | $741.31 | $5,888.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $1,621.81 | Professional | None | $524.81 | $537.03 | $1,621.81 |
Health New England Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $1,698.24 | Facility | None | $549.54 | $549.54 | $1,698.24 |
Mass General Brigham Setting Facility Modifier None Typical Low $489.78 Median $588.84 Typical High $1,737.80 | Facility | None | $489.78 | $588.84 | $1,737.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $1,174.90 | Professional | None | $524.81 | $537.03 | $1,174.90 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,174.90 | Professional | None | $524.81 | $524.81 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $575.44 Median $776.25 Typical High $1,230.27 | Facility | None | $575.44 | $776.25 | $1,230.27 |
Well Sense Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $645.65 | Professional | None | $537.03 | $537.03 | $645.65 |
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 $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Where Massachusetts sits
The same service costs 5.0 times more in Wyoming than in Alabama. 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· 45th of 51
$537
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.