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 $104.71 Median $104.71 Typical High $173.78 | Facility | None | $104.71 | $104.71 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $338.84 | Facility | None | $263.03 | $295.12 | $338.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $134.90 | Professional | None | $104.71 | $120.23 | $134.90 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $104.71 Median $120.23 Typical High $218.78 | Facility | None | $104.71 | $120.23 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $457.09 | Facility | None | $87.10 | $190.55 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Fallon Health Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $169.82 | Facility | None | $104.71 | $147.91 | $169.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $128.82 | Professional | None | $104.71 | $120.23 | $128.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $338.84 | Facility | None | $263.03 | $295.12 | $338.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $134.90 | Professional | None | $104.71 | $120.23 | $134.90 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | None | $120.23 | $120.23 | $134.90 |
Well Sense Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $245.47 | Facility | None | $128.82 | $158.49 | $245.47 |
Well Sense Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | 53 · Discontinued | $20.89 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $16.22 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.96 |
Where Massachusetts sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 11th of 51
$120
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.