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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | None | $60.26 | $60.26 | $63.10 |
AllWays Health Partners Setting Facility Modifier None Typical Low $66.07 Median $125.89 Typical High $194.98 | Facility | None | $66.07 | $125.89 | $194.98 |
AllWays Health Partners Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $85.11 | Professional | None | $60.26 | $77.62 | $85.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $123.03 | Facility | None | $60.26 | $67.61 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $107.15 Typical High $263.03 | Facility | None | $72.44 | $107.15 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Fallon Health Setting Facility Modifier None Typical Low $60.26 Median $83.18 Typical High $109.65 | Facility | None | $60.26 | $83.18 | $109.65 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $81.28 | Professional | None | $60.26 | $72.44 | $81.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $66.07 Median $125.89 Typical High $194.98 | Facility | None | $66.07 | $125.89 | $194.98 |
Mass General Brigham Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $85.11 | Professional | None | $60.26 | $77.62 | $85.11 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | None | $77.62 | $77.62 | $85.11 |
Well Sense Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $151.36 | Facility | None | $74.13 | $93.33 | $151.36 |
Well Sense Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | None | $60.26 | $60.26 | $81.28 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 21st of 51
$72.44
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.