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 $58.88 Median $58.88 Typical High $87.10 | Facility | None | $58.88 | $58.88 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | None | $58.88 | $58.88 | $60.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $64.57 Median $67.61 Typical High $190.55 | Facility | None | $64.57 | $67.61 | $190.55 |
AllWays Health Partners Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $316.23 | Professional | None | $58.88 | $63.10 | $316.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $58.88 Median $66.07 Typical High $120.23 | Facility | None | $58.88 | $66.07 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $104.71 Typical High $251.19 | Facility | None | $61.66 | $104.71 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Fallon Health Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $87.10 | Facility | None | $58.88 | $79.43 | $87.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $67.61 | Professional | None | $58.88 | $60.26 | $67.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $64.57 Median $67.61 Typical High $190.55 | Facility | None | $64.57 | $67.61 | $190.55 |
Mass General Brigham Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $316.23 | Professional | None | $58.88 | $63.10 | $316.23 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $67.61 | Professional | None | $60.26 | $60.26 | $67.61 |
Well Sense Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $134.90 | Facility | None | $66.07 | $83.18 | $134.90 |
Well Sense Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | None | $58.88 | $58.88 | $79.43 |
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 $28.84 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $5.89 |
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· 33rd of 51
$60.26
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.