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 $229.09 Median $229.09 Typical High $316.23 | Facility | None | $229.09 | $229.09 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $194.98 Median $251.19 Typical High $741.31 | Facility | None | $194.98 | $251.19 | $741.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $977.24 | Professional | None | $223.87 | $234.42 | $977.24 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $467.74 | Facility | None | $229.09 | $257.04 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $407.38 Typical High $977.24 | Facility | None | $218.78 | $407.38 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Fallon Health Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $338.84 | Facility | None | $223.87 | $295.12 | $338.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $263.03 | Professional | None | $223.87 | $229.09 | $263.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $194.98 Median $251.19 Typical High $741.31 | Facility | None | $194.98 | $251.19 | $741.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $977.24 | Professional | None | $223.87 | $234.42 | $977.24 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | None | $223.87 | $223.87 | $234.42 |
Well Sense Setting Facility Modifier None Typical Low $245.47 Median $331.13 Typical High $524.81 | Facility | None | $245.47 | $331.13 | $524.81 |
Well Sense Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $309.03 | Professional | None | $229.09 | $229.09 | $309.03 |
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 $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
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· 20th of 51
$229
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.