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 $38.02 Median $57.54 Typical High $263.03 | Facility | None | $38.02 | $57.54 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | None | $38.02 | $38.02 | $39.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $29.51 Median $95.50 Typical High $123.03 | Facility | None | $29.51 | $95.50 | $123.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $44.67 | Professional | None | $38.02 | $39.81 | $44.67 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $38.02 Median $43.65 Typical High $79.43 | Facility | None | $38.02 | $43.65 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $165.96 | Facility | None | $48.98 | $79.43 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Fallon Health Setting Facility Modifier None Typical Low $38.02 Median $52.48 Typical High $75.86 | Facility | None | $38.02 | $52.48 | $75.86 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $43.65 | Professional | None | $38.02 | $39.81 | $43.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $29.51 Median $95.50 Typical High $123.03 | Facility | None | $29.51 | $95.50 | $123.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $44.67 | Professional | None | $38.02 | $39.81 | $44.67 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $44.67 | Professional | None | $39.81 | $39.81 | $44.67 |
Well Sense Setting Facility Modifier None Typical Low $43.65 Median $54.95 Typical High $89.13 | Facility | None | $43.65 | $54.95 | $89.13 |
Well Sense Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
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 $19.05 Median $19.05 Typical High $19.95 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $5.89 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.98 |
Where Massachusetts sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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· 20th of 51
$39.81
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.