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 $31.62 Median $41.69 Typical High $45.71 | Facility | None | $31.62 | $41.69 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
AllWays Health Partners Setting Facility Modifier None Typical Low $27.54 Median $32.36 Typical High $102.33 | Facility | None | $27.54 | $32.36 | $102.33 |
AllWays Health Partners Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $33.88 | Professional | None | $30.90 | $32.36 | $33.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $32.36 Median $37.15 Typical High $67.61 | Facility | None | $32.36 | $37.15 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $56.23 Typical High $134.90 | Facility | None | $31.62 | $56.23 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
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 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $38.02 | Professional | None | $30.90 | $32.36 | $38.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $27.54 Median $32.36 Typical High $102.33 | Facility | None | $27.54 | $32.36 | $102.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $33.88 | Professional | None | $30.90 | $32.36 | $33.88 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | None | $30.90 | $30.90 | $32.36 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.16 |
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· 27th of 51
$31.62
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.