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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | None | $39.81 | $39.81 | $52.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $190.55 | Facility | None | $50.12 | $60.26 | $190.55 |
AllWays Health Partners Setting Professional Modifier None Typical Low $30.20 Median $60.26 Typical High $389.05 | Professional | None | $30.20 | $60.26 | $389.05 |
BCBS Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $891.25 | Facility | None | $295.12 | $295.12 | $891.25 |
BCBS Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $63.10 | Professional | None | $58.88 | $58.88 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
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 $30.20 Median $51.29 Typical High $70.79 | Professional | None | $30.20 | $51.29 | $70.79 |
Health New England Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $190.55 | Facility | None | $50.12 | $60.26 | $190.55 |
Mass General Brigham Setting Professional Modifier None Typical Low $30.20 Median $60.26 Typical High $389.05 | Professional | None | $30.20 | $60.26 | $389.05 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $28.84 Median $45.71 Typical High $66.07 | Professional | None | $28.84 | $45.71 | $66.07 |
Well Sense Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $104.71 | Facility | None | $53.70 | $70.79 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None | $60.26 | $60.26 | $72.44 |
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 $19.95 Median $19.95 Typical High $26.30 | Professional | 52 · Reduced service | $19.95 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $10.47 | Professional | 53 · Discontinued | $7.94 | $7.94 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $7.94 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.25 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 13th of 51
$56.23
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.