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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $660.69 | Professional | None | $467.74 | $467.74 | $660.69 |
AllWays Health Partners Setting Facility Modifier None Typical Low $616.60 Median $691.83 Typical High $1,737.80 | Facility | None | $616.60 | $691.83 | $1,737.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $354.81 Median $707.95 Typical High $4,466.84 | Professional | None | $354.81 | $707.95 | $4,466.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,819.70 | Facility | None | $1,096.48 | $1,348.96 | $1,819.70 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,258.93 | Professional | None | $676.08 | $741.31 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Facility | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
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 $354.81 Median $602.56 Typical High $812.83 | Professional | None | $354.81 | $602.56 | $812.83 |
Health New England Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | None | $676.08 | $724.44 | $724.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $616.60 Median $691.83 Typical High $1,737.80 | Facility | None | $616.60 | $691.83 | $1,737.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $354.81 Median $707.95 Typical High $4,466.84 | Professional | None | $354.81 | $707.95 | $4,466.84 |
United Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
United Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $758.58 | Professional | None | $338.84 | $524.81 | $758.58 |
Well Sense Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $1,047.13 | Facility | None | $537.03 | $707.95 | $1,047.13 |
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 $229.09 Median $229.09 Typical High $309.03 | Professional | 52 · Reduced service | $229.09 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | 53 · Discontinued | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $93.33 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $61.66 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $61.66 |
Where Massachusetts sits
The same service costs 2.2 times more in Kansas 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· 17th of 51
$676
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.