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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $1,995.26 | Facility | None | $630.96 | $645.65 | $1,995.26 |
AllWays Health Partners Setting Professional Modifier None Typical Low $288.40 Median $691.83 Typical High $3,548.13 | Professional | None | $288.40 | $691.83 | $3,548.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $218.78 Median $851.14 Typical High $1,148.15 | Facility | None | $218.78 | $851.14 | $1,148.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $467.74 | Professional | None | $436.52 | $436.52 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | None | $316.23 | $316.23 | $446.68 |
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 $263.03 Median $588.84 Typical High $616.60 | Professional | None | $263.03 | $588.84 | $616.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $1,995.26 | Facility | None | $630.96 | $645.65 | $1,995.26 |
Mass General Brigham Setting Professional Modifier None Typical Low $288.40 Median $691.83 Typical High $3,548.13 | Professional | None | $288.40 | $691.83 | $3,548.13 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $660.69 | Professional | None | $223.87 | $338.84 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $457.09 Median $630.96 Typical High $891.25 | Facility | None | $457.09 | $630.96 | $891.25 |
Well Sense Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | None | $446.68 | $446.68 | $524.81 |
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 $147.91 Median $147.91 Typical High $199.53 | Professional | 52 · Reduced service | $147.91 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | 53 · Discontinued | $58.88 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $58.88 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $39.81 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $39.81 |
Where Massachusetts sits
The same service costs 2.3 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· 18th of 51
$490
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.