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 $331.13 Median $331.13 Typical High $467.74 | Facility | None | $331.13 | $331.13 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $281.84 Median $363.08 Typical High $1,071.52 | Facility | None | $281.84 | $363.08 | $1,071.52 |
AllWays Health Partners Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $1,445.44 | Professional | None | $323.59 | $338.84 | $1,445.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $331.13 Median $371.54 Typical High $676.08 | Facility | None | $331.13 | $371.54 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,445.44 | Facility | None | $323.59 | $588.84 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Fallon Health Setting Facility Modifier None Typical Low $323.59 Median $426.58 Typical High $501.19 | Facility | None | $323.59 | $426.58 | $501.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $380.19 | Professional | None | $323.59 | $331.13 | $380.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $281.84 Median $363.08 Typical High $1,071.52 | Facility | None | $281.84 | $363.08 | $1,071.52 |
Mass General Brigham Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $1,445.44 | Professional | None | $323.59 | $338.84 | $1,445.44 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | None | $323.59 | $323.59 | $338.84 |
Well Sense Setting Facility Modifier None Typical Low $354.81 Median $478.63 Typical High $776.25 | Facility | None | $354.81 | $478.63 | $776.25 |
Well Sense Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
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· 44th of 51
$331
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.