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 $33.88 Median $33.88 Typical High $60.26 | Facility | None | $33.88 | $33.88 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | None | $33.88 | $33.88 | $47.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $53.70 Median $93.33 Typical High $309.03 | Facility | None | $53.70 | $93.33 | $309.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $35.48 | Professional | None | $28.18 | $30.20 | $35.48 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $33.88 Median $38.90 Typical High $70.79 | Facility | None | $33.88 | $38.90 | $70.79 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $60.26 | Professional | None | $33.88 | $47.86 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $61.66 Typical High $147.91 | Facility | None | $26.30 | $61.66 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Fallon Health Setting Facility Modifier None Typical Low $33.88 Median $42.66 Typical High $56.23 | Facility | None | $33.88 | $42.66 | $56.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $28.18 Median $33.88 Typical High $39.81 | Professional | None | $28.18 | $33.88 | $39.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $53.70 Median $93.33 Typical High $309.03 | Facility | None | $53.70 | $93.33 | $309.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $35.48 | Professional | None | $28.18 | $30.20 | $35.48 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $31.62 | Professional | None | $28.18 | $28.18 | $31.62 |
Well Sense Setting Facility Modifier None Typical Low $31.62 Median $45.71 Typical High $79.43 | Facility | None | $31.62 | $45.71 | $79.43 |
Well Sense Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | None | $33.88 | $33.88 | $45.71 |
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 $16.98 Median $16.98 Typical High $17.78 | Professional | 52 · Reduced service | $16.98 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 53 · Discontinued | $6.76 | $6.76 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.37 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.55 |
Where Massachusetts sits
The same service costs 5.4 times more in Wyoming than in Arizona. 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· 40th of 51
$33.88
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.