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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | None | $213.80 | $213.80 | $245.47 |
AllWays Health Partners Setting Facility Modifier None Typical Low $204.17 Median $537.03 Typical High $691.83 | Facility | None | $204.17 | $537.03 | $691.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $323.59 | Professional | None | $208.93 | $213.80 | $323.59 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $436.52 | Facility | None | $213.80 | $245.47 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $933.25 | Facility | None | $275.42 | $446.68 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | None | $213.80 | $213.80 | $263.03 |
Fallon Health Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $323.59 | Facility | None | $213.80 | $275.42 | $323.59 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $363.08 | Professional | None | $213.80 | $213.80 | $363.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $204.17 Median $537.03 Typical High $691.83 | Facility | None | $204.17 | $537.03 | $691.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $323.59 | Professional | None | $208.93 | $213.80 | $323.59 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $363.08 | Professional | None | $208.93 | $213.80 | $363.08 |
Well Sense Setting Facility Modifier None Typical Low $234.42 Median $316.23 Typical High $501.19 | Facility | None | $234.42 | $316.23 | $501.19 |
Well Sense Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | None | $213.80 | $213.80 | $257.04 |
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 $107.15 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $21.38 |
Where Massachusetts sits
The same service costs 7.6 times more in Alabama than in New Mexico. 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· 28th of 51
$214
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.