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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
AllWays Health Partners Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $616.60 | Facility | None | $162.18 | $208.93 | $616.60 |
AllWays Health Partners Setting Professional Modifier None Typical Low $186.21 Median $190.55 Typical High $199.53 | Professional | None | $186.21 | $190.55 | $199.53 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $190.55 Median $218.78 Typical High $389.05 | Facility | None | $190.55 | $218.78 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $338.84 Typical High $831.76 | Facility | None | $186.21 | $338.84 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Fallon Health Setting Facility Modifier None Typical Low $186.21 Median $245.47 Typical High $281.84 | Facility | None | $186.21 | $245.47 | $281.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $186.21 Median $190.55 Typical High $218.78 | Professional | None | $186.21 | $190.55 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $616.60 | Facility | None | $162.18 | $208.93 | $616.60 |
Mass General Brigham Setting Professional Modifier None Typical Low $186.21 Median $190.55 Typical High $199.53 | Professional | None | $186.21 | $190.55 | $199.53 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | None | $186.21 | $186.21 | $199.53 |
Well Sense Setting Facility Modifier None Typical Low $204.17 Median $281.84 Typical High $446.68 | Facility | None | $204.17 | $281.84 | $446.68 |
Well Sense Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $257.04 | Professional | None | $190.55 | $190.55 | $257.04 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
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· 51st of 51
$191
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.