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 $43.65 Median $43.65 Typical High $63.10 | Facility | None | $43.65 | $43.65 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
AllWays Health Partners Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $141.25 | Facility | None | $74.13 | $100.00 | $141.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $229.09 | Professional | None | $30.20 | $42.66 | $229.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $218.78 Median $234.42 Typical High $323.59 | Facility | None | $218.78 | $234.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $63.10 Typical High $128.82 | Facility | None | $38.90 | $63.10 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $83.18 | Facility | None | $56.23 | $83.18 | $83.18 |
Fallon Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | None | $40.74 | $40.74 | $46.77 |
Mass General Brigham Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $141.25 | Facility | None | $74.13 | $100.00 | $141.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $229.09 | Professional | None | $30.20 | $42.66 | $229.09 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | None | $40.74 | $40.74 | $42.66 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Where Massachusetts sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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
$40.74
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.