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 $281.84 Median $281.84 Typical High $489.78 | Facility | None | $281.84 | $281.84 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | None | $281.84 | $281.84 | $288.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $912.01 | Facility | None | $204.17 | $309.03 | $912.01 |
AllWays Health Partners Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $295.12 | Professional | None | $269.15 | $281.84 | $295.12 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $281.84 Median $316.23 Typical High $575.44 | Facility | None | $281.84 | $316.23 | $575.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $562.34 | Professional | None | $281.84 | $371.54 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $501.19 Typical High $1,202.26 | Facility | None | $269.15 | $501.19 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Fallon Health Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $416.87 | Facility | None | $269.15 | $363.08 | $416.87 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $323.59 | Professional | None | $269.15 | $281.84 | $323.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $912.01 | Facility | None | $204.17 | $309.03 | $912.01 |
Mass General Brigham Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $295.12 | Professional | None | $269.15 | $281.84 | $295.12 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $281.84 | Professional | None | $269.15 | $269.15 | $281.84 |
Well Sense Setting Facility Modifier None Typical Low $295.12 Median $407.38 Typical High $645.65 | Facility | None | $295.12 | $407.38 | $645.65 |
Well Sense Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $380.19 | Professional | None | $281.84 | $281.84 | $380.19 |
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 $138.04 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
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· 28th of 51
$282
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.