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 $173.78 Median $173.78 Typical High $234.42 | Facility | None | $173.78 | $173.78 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | None | $173.78 | $173.78 | $177.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $131.83 Median $190.55 Typical High $562.34 | Facility | None | $131.83 | $190.55 | $562.34 |
AllWays Health Partners Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $181.97 | Professional | None | $162.18 | $173.78 | $181.97 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $173.78 Median $194.98 Typical High $354.81 | Facility | None | $173.78 | $194.98 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $309.03 Typical High $758.58 | Facility | None | $162.18 | $309.03 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Fallon Health Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $251.19 | Facility | None | $162.18 | $223.87 | $251.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $199.53 | Professional | None | $162.18 | $173.78 | $199.53 |
Mass General Brigham Setting Facility Modifier None Typical Low $131.83 Median $190.55 Typical High $562.34 | Facility | None | $131.83 | $190.55 | $562.34 |
Mass General Brigham Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $181.97 | Professional | None | $162.18 | $173.78 | $181.97 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | None | $162.18 | $162.18 | $173.78 |
Well Sense Setting Facility Modifier None Typical Low $181.97 Median $239.88 Typical High $398.11 | Facility | None | $181.97 | $239.88 | $398.11 |
Well Sense Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
5 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 $87.10 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.38 |
Where Massachusetts sits
Rates are fairly even across states for this service. 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
$174
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.