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 $3,890.45 Median $5,011.87 Typical High $7,244.36 | Facility | None | $3,890.45 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $4,677.35 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,677.35 | $5,011.87 | $5,011.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $5,128.61 Median $6,309.57 Typical High $8,317.64 | Facility | None | $5,128.61 | $6,309.57 | $8,317.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $24,547.09 | Professional | None | $4,897.79 | $5,128.61 | $24,547.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $5,128.61 Median $5,888.44 Typical High $10,715.19 | Facility | None | $5,128.61 | $5,888.44 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $6,456.54 Median $10,471.29 Typical High $21,379.62 | Facility | None | $6,456.54 | $10,471.29 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $8,511.38 | Facility | None | $83.18 | $3,630.78 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $6,025.60 | Professional | None | $4,897.79 | $5,128.61 | $6,025.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $5,128.61 Median $6,309.57 Typical High $8,317.64 | Facility | None | $5,128.61 | $6,309.57 | $8,317.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $24,547.09 | Professional | None | $4,897.79 | $5,128.61 | $24,547.09 |
United Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,128.61 | Professional | None | $4,897.79 | $4,897.79 | $5,128.61 |
Well Sense Setting Facility Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $5,754.40 | Facility | None | $3,090.30 | $3,801.89 | $5,754.40 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
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 $2,344.23 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,344.23 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $933.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $707.95 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $467.74 | $501.19 | $501.19 |
Where Massachusetts sits
The same service costs 1.8 times more in Alaska than in North 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· 12th of 51
$5,129
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.