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 $50.12 Median $50.12 Typical High $229.09 | Facility | None | $50.12 | $50.12 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $229.09 | Professional | None | $50.12 | $50.12 | $229.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $109.65 Median $120.23 Typical High $363.08 | Facility | None | $109.65 | $120.23 | $363.08 |
AllWays Health Partners Setting Professional Modifier None Typical Low $51.29 Median $117.49 Typical High $812.83 | Professional | None | $51.29 | $117.49 | $812.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $204.17 | Facility | None | $67.61 | $67.61 | $204.17 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | None | $75.86 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $81.28 | Facility | None | $67.61 | $75.86 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | None | $54.95 | $54.95 | $77.62 |
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 $45.71 Median $97.72 Typical High $104.71 | Professional | None | $45.71 | $97.72 | $104.71 |
Health New England Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $109.65 Median $120.23 Typical High $363.08 | Facility | None | $109.65 | $120.23 | $363.08 |
Mass General Brigham Setting Professional Modifier None Typical Low $51.29 Median $117.49 Typical High $812.83 | Professional | None | $51.29 | $117.49 | $812.83 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $158.49 | Facility | None | $77.62 | $87.10 | $158.49 |
United Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $112.20 | Professional | None | $38.90 | $57.54 | $112.20 |
Well Sense Setting Facility Modifier None Typical Low $91.20 Median $123.03 Typical High $177.83 | Facility | None | $91.20 | $123.03 | $177.83 |
Well Sense Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | None | $70.79 | $70.79 | $85.11 |
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 $25.12 Median $25.12 Typical High $114.82 | Professional | 52 · Reduced service | $25.12 | $25.12 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $46.77 | Professional | 53 · Discontinued | $10.23 | $10.23 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $34.67 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $22.91 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $22.91 |
Where Massachusetts sits
The same service costs 4.4 times more in Kansas than in Vermont. 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.