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 $28.84 Median $35.48 Typical High $40.74 | Facility | None | $28.84 | $35.48 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | None | $28.84 | $28.84 | $30.20 |
AllWays Health Partners Setting Facility Modifier None Typical Low $46.77 Median $85.11 Typical High $234.42 | Facility | None | $46.77 | $85.11 | $234.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $24.55 Median $26.30 Typical High $31.62 | Professional | None | $24.55 | $26.30 | $31.62 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $28.84 Median $33.11 Typical High $58.88 | Facility | None | $28.84 | $33.11 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $51.29 Typical High $125.89 | Facility | None | $26.30 | $51.29 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Fallon Health Setting Facility Modifier None Typical Low $28.84 Median $39.81 Typical High $57.54 | Facility | None | $28.84 | $39.81 | $57.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $33.11 | Professional | None | $24.55 | $28.84 | $33.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $46.77 Median $85.11 Typical High $234.42 | Facility | None | $46.77 | $85.11 | $234.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $24.55 Median $26.30 Typical High $31.62 | Professional | None | $24.55 | $26.30 | $31.62 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $28.18 | Professional | None | $24.55 | $24.55 | $28.18 |
Well Sense Setting Facility Modifier None Typical Low $27.54 Median $39.81 Typical High $67.61 | Facility | None | $27.54 | $39.81 | $67.61 |
Well Sense Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
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 $14.45 Median $14.45 Typical High $15.14 | Professional | 52 · Reduced service | $14.45 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 53 · Discontinued | $5.75 | $5.75 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.47 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.02 |
Where Massachusetts sits
The same service costs 2.8 times more in Wyoming than in Arizona. 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· 34th of 51
$28.84
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.