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 $50.12 Median $50.12 Typical High $72.44 | Facility | None | $50.12 | $50.12 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $97.72 Typical High $131.83 | Facility | None | $52.48 | $97.72 | $131.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $63.10 | Professional | None | $52.48 | $58.88 | $63.10 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $52.48 Median $58.88 Typical High $107.15 | Facility | None | $52.48 | $58.88 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $93.33 Typical High $223.87 | Facility | None | $52.48 | $93.33 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $83.18 | Facility | None | $56.23 | $83.18 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $63.10 | Professional | None | $52.48 | $58.88 | $63.10 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $97.72 Typical High $131.83 | Facility | None | $52.48 | $97.72 | $131.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $63.10 | Professional | None | $52.48 | $58.88 | $63.10 |
United Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $63.10 | Professional | None | $58.88 | $58.88 | $63.10 |
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 $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.01 |
Where Massachusetts sits
The same service costs 1.6 times more in Alaska than in Pennsylvania. 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· 3rd of 51
$58.88
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.