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 $56.23 Median $56.23 Typical High $257.04 | Facility | None | $56.23 | $56.23 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $257.04 | Professional | None | $56.23 | $56.23 | $257.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $123.03 Median $131.83 Typical High $398.11 | Facility | None | $123.03 | $131.83 | $398.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $57.54 Median $131.83 Typical High $912.01 | Professional | None | $57.54 | $131.83 | $912.01 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $223.87 | Facility | None | $74.13 | $74.13 | $223.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | None | $83.18 | $83.18 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $81.28 Typical High $87.10 | Facility | None | $74.13 | $81.28 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
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 $50.12 Median $109.65 Typical High $117.49 | Professional | None | $50.12 | $109.65 | $117.49 |
Health New England Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $123.03 Median $131.83 Typical High $398.11 | Facility | None | $123.03 | $131.83 | $398.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $57.54 Median $131.83 Typical High $912.01 | Professional | None | $57.54 | $131.83 | $912.01 |
United Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $173.78 | Facility | None | $79.43 | $85.11 | $173.78 |
United Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $125.89 | Professional | None | $42.66 | $64.57 | $125.89 |
Well Sense Setting Facility Modifier None Typical Low $100.00 Median $134.90 Typical High $199.53 | Facility | None | $100.00 | $134.90 | $199.53 |
Well Sense Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | None | $79.43 | $79.43 | $95.50 |
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 $28.18 Median $28.18 Typical High $128.82 | Professional | 52 · Reduced service | $28.18 | $28.18 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $51.29 | Professional | 53 · Discontinued | $11.22 | $11.22 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $38.90 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $25.70 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $25.70 |
Where Massachusetts sits
The same service costs 5.1 times more in Kansas 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· 18th of 51
$89.13
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.