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 $316.23 Median $389.05 Typical High $457.09 | Facility | None | $316.23 | $389.05 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $11.75 Median $28.18 Typical High $323.59 | Facility | None | $11.75 | $28.18 | $323.59 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $1,318.26 | Professional | None | $309.03 | $331.13 | $1,318.26 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $660.69 | Facility | None | $323.59 | $363.08 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $575.44 Typical High $1,412.54 | Facility | None | $323.59 | $575.44 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $2,951.21 | Facility | None | $56.23 | $83.18 | $2,951.21 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $371.54 | Professional | None | $309.03 | $323.59 | $371.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $11.75 Median $28.18 Typical High $323.59 | Facility | None | $11.75 | $28.18 | $323.59 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $1,318.26 | Professional | None | $309.03 | $331.13 | $1,318.26 |
United Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $331.13 | Professional | None | $309.03 | $309.03 | $331.13 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,090.30 | Facility | None | $2,511.89 | $3,090.30 | $3,090.30 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Where Massachusetts sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 13th of 51
$324
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.