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 $30.90 Median $30.90 Typical High $44.67 | Facility | None | $30.90 | $30.90 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $6.03 Median $19.05 Typical High $67.61 | Facility | None | $6.03 | $19.05 | $67.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $6.03 Median $30.20 Typical High $44.67 | Professional | None | $6.03 | $30.20 | $44.67 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $34.67 Median $38.90 Typical High $70.79 | Facility | None | $34.67 | $38.90 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $64.57 Typical High $134.90 | Facility | None | $39.81 | $64.57 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $35.48 | Professional | None | $30.20 | $30.90 | $35.48 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.03 Median $19.05 Typical High $67.61 | Facility | None | $6.03 | $19.05 | $67.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $6.03 Median $30.20 Typical High $44.67 | Professional | None | $6.03 | $30.20 | $44.67 |
United Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $31.62 | Professional | None | $30.20 | $30.20 | $31.62 |
Well Sense Setting Facility Modifier None Typical Low $36.31 Median $42.66 Typical High $63.10 | Facility | None | $36.31 | $42.66 | $63.10 |
Well Sense Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
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 $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Where Massachusetts sits
The same service costs 4.7 times more in Alaska than in Hawaii. 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· 33rd of 51
$30.90
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.