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 $407.38 Median $407.38 Typical High $562.34 | Facility | None | $407.38 | $407.38 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $1,737.80 | Professional | None | $389.05 | $501.19 | $1,737.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $407.38 Median $467.74 Typical High $851.14 | Facility | None | $407.38 | $467.74 | $851.14 |
Fallon Health Setting Facility Modifier None Typical Low $389.05 Median $537.03 Typical High $630.96 | Facility | None | $389.05 | $537.03 | $630.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | None | $389.05 | $389.05 | $416.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $1,737.80 | Professional | None | $389.05 | $501.19 | $1,737.80 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | None | $389.05 | $389.05 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $389.05 Median $524.81 Typical High $891.25 | Facility | None | $389.05 | $524.81 | $891.25 |
Well Sense Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | None | $407.38 | $407.38 | $489.78 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Where Massachusetts sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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
$407
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.