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 $13.18 Median $13.18 Typical High $60.26 | Facility | None | $13.18 | $13.18 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $60.26 | Professional | None | $13.18 | $13.18 | $60.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $28.18 Median $31.62 Typical High $93.33 | Facility | None | $28.18 | $31.62 | $93.33 |
AllWays Health Partners Setting Professional Modifier None Typical Low $12.88 Median $30.20 Typical High $251.19 | Professional | None | $12.88 | $30.20 | $251.19 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $30.20 Median $38.90 Typical High $52.48 | Facility | None | $30.20 | $38.90 | $52.48 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $17.78 Median $19.95 Typical High $33.88 | Professional | None | $17.78 | $19.95 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $17.38 Median $22.39 Typical High $24.55 | Facility | None | $17.38 | $22.39 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $11.75 Median $25.70 Typical High $26.92 | Professional | None | $11.75 | $25.70 | $26.92 |
Health New England Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $16.22 | Professional | None | $15.14 | $15.14 | $16.22 |
Mass General Brigham Setting Facility Modifier None Typical Low $28.18 Median $31.62 Typical High $93.33 | Facility | None | $28.18 | $31.62 | $93.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $12.88 Median $30.20 Typical High $251.19 | Professional | None | $12.88 | $30.20 | $251.19 |
United Setting Facility Modifier None Typical Low $19.95 Median $28.18 Typical High $40.74 | Facility | None | $19.95 | $28.18 | $40.74 |
United Setting Professional Modifier None Typical Low $10.00 Median $14.79 Typical High $29.51 | Professional | None | $10.00 | $14.79 | $29.51 |
Well Sense Setting Facility Modifier None Typical Low $19.95 Median $28.18 Typical High $39.81 | Facility | None | $19.95 | $28.18 | $39.81 |
Well Sense Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $20.89 | Professional | None | $17.38 | $17.38 | $20.89 |
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 $6.46 Median $6.46 Typical High $30.20 | Professional | 52 · Reduced service | $6.46 | $6.46 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $12.02 | Professional | 53 · Discontinued | $2.63 | $2.63 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $6.03 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $6.03 |
Where Massachusetts sits
The same service costs 3.7 times more in Hawaii 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· 22nd of 51
$22.39
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.