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 $14.45 Median $52.48 Typical High $74.13 | Facility | None | $14.45 | $52.48 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $52.48 | Professional | None | $48.98 | $52.48 | $52.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $11.75 Median $26.30 Typical High $257.04 | Facility | None | $11.75 | $26.30 | $257.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $8.91 Median $52.48 Typical High $407.38 | Professional | None | $8.91 | $52.48 | $407.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $57.54 Median $66.07 Typical High $120.23 | Facility | None | $57.54 | $66.07 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $93.33 Typical High $223.87 | Facility | None | $51.29 | $93.33 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
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 $8.91 Median $42.66 Typical High $52.48 | Professional | None | $8.91 | $42.66 | $52.48 |
Mass General Brigham Setting Facility Modifier None Typical Low $11.75 Median $26.30 Typical High $257.04 | Facility | None | $11.75 | $26.30 | $257.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $8.91 Median $52.48 Typical High $407.38 | Professional | None | $8.91 | $52.48 | $407.38 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | None | $50.12 | $50.12 | $56.23 |
Well Sense Setting Facility Modifier None Typical Low $56.23 Median $74.13 Typical High $123.03 | Facility | None | $56.23 | $74.13 | $123.03 |
Well Sense Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $70.79 | Professional | None | $52.48 | $52.48 | $70.79 |
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 $24.55 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $24.55 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $9.77 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $5.25 |
Where Massachusetts sits
The same service costs 6.6 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· 9th of 51
$52.48
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.