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 $245.47 Median $245.47 Typical High $257.04 | Facility | None | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | None | $251.19 | $257.04 | $257.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $42.66 Median $194.98 Typical High $257.04 | Facility | None | $42.66 | $194.98 | $257.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $42.66 Median $251.19 Typical High $281.84 | Professional | None | $42.66 | $251.19 | $281.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $281.84 Median $323.59 Typical High $588.84 | Facility | None | $281.84 | $323.59 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $794.33 | Facility | None | $257.04 | $257.04 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | None | $257.04 | $257.04 | $281.84 |
Fallon Health Setting Facility Modifier None Typical Low $64.57 Median $331.13 Typical High $380.19 | Facility | None | $64.57 | $331.13 | $380.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $100.00 Median $257.04 Typical High $389.05 | Professional | None | $100.00 | $257.04 | $389.05 |
Mass General Brigham Setting Facility Modifier None Typical Low $42.66 Median $194.98 Typical High $257.04 | Facility | None | $42.66 | $194.98 | $257.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $42.66 Median $251.19 Typical High $281.84 | Professional | None | $42.66 | $251.19 | $281.84 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $346.74 | Professional | None | $100.00 | $251.19 | $346.74 |
Well Sense Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $501.19 | Facility | None | $257.04 | $363.08 | $501.19 |
Well Sense Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | None | $257.04 | $257.04 | $309.03 |
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 $125.89 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $50.12 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $25.70 |
Where Massachusetts sits
The same service costs 4.1 times more in Alaska than in Montana. 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· 16th of 51
$257
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.