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 $28.84 Median $28.84 Typical High $131.83 | Facility | None | $28.84 | $28.84 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $131.83 | Professional | None | $28.84 | $28.84 | $131.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $60.26 Median $64.57 Typical High $208.93 | Facility | None | $60.26 | $64.57 | $208.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $28.18 Median $67.61 Typical High $407.38 | Professional | None | $28.18 | $67.61 | $407.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $117.49 | Facility | None | $38.02 | $38.02 | $117.49 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $51.29 | Professional | None | $43.65 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $40.74 Typical High $43.65 | Facility | None | $38.02 | $40.74 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $41.69 | Professional | None | $29.51 | $29.51 | $41.69 |
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 $25.70 Median $56.23 Typical High $60.26 | Professional | None | $25.70 | $56.23 | $60.26 |
Health New England Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $60.26 Median $64.57 Typical High $208.93 | Facility | None | $60.26 | $64.57 | $208.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $28.18 Median $67.61 Typical High $407.38 | Professional | None | $28.18 | $67.61 | $407.38 |
United Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $85.11 | Facility | None | $36.31 | $40.74 | $85.11 |
United Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $64.57 | Professional | None | $21.88 | $33.11 | $64.57 |
Well Sense Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $117.49 | Facility | None | $58.88 | $79.43 | $117.49 |
Well Sense Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | None | $43.65 | $43.65 | $51.29 |
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 $14.45 Median $14.45 Typical High $66.07 | Professional | 52 · Reduced service | $14.45 | $14.45 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $26.30 | Professional | 53 · Discontinued | $5.75 | $5.75 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $19.95 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $13.18 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $13.18 |
Where Massachusetts sits
The same service costs 2.7 times more in Montana than in Delaware. 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· 17th of 51
$51.29
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.