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 $204.17 Median $204.17 Typical High $288.40 | Facility | None | $204.17 | $204.17 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $213.80 | Professional | None | $204.17 | $204.17 | $213.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $676.08 | Facility | None | $181.97 | $223.87 | $676.08 |
AllWays Health Partners Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $891.25 | Professional | None | $199.53 | $213.80 | $891.25 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $426.58 | Facility | None | $204.17 | $234.42 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $371.54 Typical High $891.25 | Facility | None | $199.53 | $371.54 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Fallon Health Setting Facility Modifier None Typical Low $199.53 Median $269.15 Typical High $309.03 | Facility | None | $199.53 | $269.15 | $309.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $239.88 | Professional | None | $199.53 | $204.17 | $239.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $676.08 | Facility | None | $181.97 | $223.87 | $676.08 |
Mass General Brigham Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $891.25 | Professional | None | $199.53 | $213.80 | $891.25 |
United Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | None | $199.53 | $199.53 | $213.80 |
Well Sense Setting Facility Modifier None Typical Low $223.87 Median $302.00 Typical High $478.63 | Facility | None | $223.87 | $302.00 | $478.63 |
Well Sense Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
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 $102.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
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· 27th of 51
$204
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.