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 $70.79 Median $104.71 Typical High $173.78 | Facility | None | $70.79 | $104.71 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $95.50 | Professional | None | $70.79 | $70.79 | $95.50 |
AllWays Health Partners Setting Facility Modifier None Typical Low $77.62 Median $85.11 Typical High $229.09 | Facility | None | $77.62 | $85.11 | $229.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $83.18 | Professional | None | $70.79 | $74.13 | $83.18 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $70.79 Median $79.43 Typical High $144.54 | Facility | None | $70.79 | $79.43 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $125.89 Typical High $302.00 | Facility | None | $74.13 | $125.89 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Fallon Health Setting Facility Modifier None Typical Low $70.79 Median $95.50 Typical High $107.15 | Facility | None | $70.79 | $95.50 | $107.15 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $81.28 | Professional | None | $70.79 | $74.13 | $81.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $77.62 Median $85.11 Typical High $229.09 | Facility | None | $77.62 | $85.11 | $229.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $83.18 | Professional | None | $70.79 | $74.13 | $83.18 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $83.18 | Professional | None | $74.13 | $74.13 | $83.18 |
Well Sense Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $162.18 | Facility | None | $81.28 | $102.33 | $162.18 |
Well Sense Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $95.50 | Professional | None | $70.79 | $70.79 | $95.50 |
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 $35.48 Median $35.48 Typical High $36.31 | Professional | 52 · Reduced service | $35.48 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.45 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.24 |
Where Massachusetts sits
The same service costs 1.5 times more in Wyoming than in Florida. 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
$74.13
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.