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 $36.31 Median $36.31 Typical High $52.48 | Facility | None | $36.31 | $36.31 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $117.49 | Facility | None | $38.02 | $39.81 | $117.49 |
AllWays Health Partners Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $177.83 | Professional | None | $36.31 | $38.90 | $177.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $36.31 Median $41.69 Typical High $75.86 | Facility | None | $36.31 | $41.69 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $66.07 Typical High $158.49 | Facility | None | $37.15 | $66.07 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Fallon Health Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $57.54 | Facility | None | $36.31 | $50.12 | $57.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | None | $36.31 | $36.31 | $41.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $117.49 | Facility | None | $38.02 | $39.81 | $117.49 |
Mass General Brigham Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $177.83 | Professional | None | $36.31 | $38.90 | $177.83 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $40.74 | Professional | None | $36.31 | $36.31 | $40.74 |
Well Sense Setting Facility Modifier None Typical Low $39.81 Median $53.70 Typical High $85.11 | Facility | None | $39.81 | $53.70 | $85.11 |
Well Sense Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | None | $36.31 | $36.31 | $48.98 |
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 $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
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· 46th of 51
$36.31
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.