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 $38.02 Median $38.02 Typical High $52.48 | Facility | None | $38.02 | $38.02 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | None | $38.02 | $38.02 | $38.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $32.36 Median $41.69 Typical High $123.03 | Facility | None | $32.36 | $41.69 | $123.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $162.18 | Professional | None | $37.15 | $38.90 | $162.18 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $38.02 Median $42.66 Typical High $77.62 | Facility | None | $38.02 | $42.66 | $77.62 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $69.18 | Professional | None | $38.02 | $52.48 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $67.61 Typical High $162.18 | Facility | None | $37.15 | $67.61 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Fallon Health Setting Facility Modifier None Typical Low $38.02 Median $51.29 Typical High $58.88 | Facility | None | $38.02 | $51.29 | $58.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $43.65 | Professional | None | $37.15 | $38.02 | $43.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $32.36 Median $41.69 Typical High $123.03 | Facility | None | $32.36 | $41.69 | $123.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $162.18 | Professional | None | $37.15 | $38.90 | $162.18 |
Tufts Setting Facility Modifier None Typical Low $31.62 Median $53.70 Typical High $72.44 | Facility | None | $31.62 | $53.70 | $72.44 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | None | $37.15 | $37.15 | $38.90 |
Well Sense Setting Facility Modifier None Typical Low $40.74 Median $54.95 Typical High $87.10 | Facility | None | $40.74 | $54.95 | $87.10 |
Well Sense Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
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· 16th of 51
$38.02
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.