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 $33.11 Median $33.11 Typical High $44.67 | Facility | None | $33.11 | $33.11 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.88 | Professional | None | $33.11 | $33.11 | $33.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $25.12 Median $36.31 Typical High $107.15 | Facility | None | $25.12 | $36.31 | $107.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $138.04 | Professional | None | $30.90 | $33.11 | $138.04 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $33.11 Median $37.15 Typical High $67.61 | Facility | None | $33.11 | $37.15 | $67.61 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $66.07 | Professional | None | $33.11 | $42.66 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $58.88 Typical High $141.25 | Facility | None | $31.62 | $58.88 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Fallon Health Setting Facility Modifier None Typical Low $33.11 Median $43.65 Typical High $56.23 | Facility | None | $33.11 | $43.65 | $56.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $38.02 | Professional | None | $30.90 | $33.11 | $38.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $25.12 Median $36.31 Typical High $107.15 | Facility | None | $25.12 | $36.31 | $107.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $138.04 | Professional | None | $30.90 | $33.11 | $138.04 |
Tufts Setting Facility Modifier None Typical Low $25.70 Median $39.81 Typical High $61.66 | Facility | None | $25.70 | $39.81 | $61.66 |
United Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.11 | Professional | None | $30.90 | $30.90 | $33.11 |
Well Sense Setting Facility Modifier None Typical Low $34.67 Median $47.86 Typical High $75.86 | Facility | None | $34.67 | $47.86 | $75.86 |
Well Sense Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | None | $33.11 | $33.11 | $44.67 |
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 $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
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· 22nd of 51
$33.11
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.