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 $43.65 Median $43.65 Typical High $60.26 | Facility | None | $43.65 | $43.65 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | None | $43.65 | $43.65 | $45.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $35.48 Median $47.86 Typical High $141.25 | Facility | None | $35.48 | $47.86 | $141.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $45.71 | Professional | None | $42.66 | $43.65 | $45.71 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $43.65 Median $50.12 Typical High $89.13 | Facility | None | $43.65 | $50.12 | $89.13 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $77.62 | Professional | None | $43.65 | $43.65 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $77.62 Typical High $190.55 | Facility | None | $42.66 | $77.62 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Fallon Health Setting Facility Modifier None Typical Low $43.65 Median $56.23 Typical High $67.61 | Facility | None | $43.65 | $56.23 | $67.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $50.12 | Professional | None | $42.66 | $43.65 | $50.12 |
Mass General Brigham Setting Facility Modifier None Typical Low $35.48 Median $47.86 Typical High $141.25 | Facility | None | $35.48 | $47.86 | $141.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $45.71 | Professional | None | $42.66 | $43.65 | $45.71 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | None | $42.66 | $42.66 | $44.67 |
Well Sense Setting Facility Modifier None Typical Low $46.77 Median $64.57 Typical High $102.33 | Facility | None | $46.77 | $64.57 | $102.33 |
Well Sense Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $58.88 | Professional | None | $43.65 | $43.65 | $58.88 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
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· 34th of 51
$43.65
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.