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 $91.20 Median $91.20 Typical High $416.87 | Facility | None | $91.20 | $91.20 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $416.87 | Professional | None | $91.20 | $91.20 | $416.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $173.78 Median $194.98 Typical High $512.86 | Facility | None | $173.78 | $194.98 | $512.86 |
AllWays Health Partners Setting Professional Modifier None Typical Low $85.11 Median $208.93 Typical High $1,071.52 | Professional | None | $85.11 | $208.93 | $1,071.52 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | None | $134.90 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $147.91 | Facility | None | $144.54 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
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 $81.28 Median $177.83 Typical High $186.21 | Professional | None | $81.28 | $177.83 | $186.21 |
Health New England Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $173.78 Median $194.98 Typical High $512.86 | Facility | None | $173.78 | $194.98 | $512.86 |
Mass General Brigham Setting Professional Modifier None Typical Low $85.11 Median $208.93 Typical High $1,071.52 | Professional | None | $85.11 | $208.93 | $1,071.52 |
United Setting Facility Modifier None Typical Low $102.33 Median $257.04 Typical High $257.04 | Facility | None | $102.33 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $204.17 | Professional | None | $69.18 | $102.33 | $204.17 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $316.23 | Facility | None | $162.18 | $218.78 | $316.23 |
Well Sense Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | None | $128.82 | $128.82 | $154.88 |
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 $45.71 Median $45.71 Typical High $208.93 | Professional | 52 · Reduced service | $45.71 | $45.71 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $83.18 | Professional | 53 · Discontinued | $18.20 | $18.20 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $61.66 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $41.69 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $41.69 |
Where Massachusetts sits
The same service costs 5.4 times more in Kansas than in West Virginia. 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· 19th of 51
$148
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.