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 $67.61 Median $67.61 Typical High $309.03 | Facility | None | $67.61 | $67.61 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $309.03 | Professional | None | $67.61 | $67.61 | $309.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $489.78 | Facility | None | $128.82 | $147.91 | $489.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $60.26 Median $158.49 Typical High $912.01 | Professional | None | $60.26 | $158.49 | $912.01 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $275.42 | Facility | None | $89.13 | $89.13 | $275.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | None | $102.33 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $102.33 Typical High $109.65 | Facility | None | $89.13 | $102.33 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | None | $75.86 | $75.86 | $104.71 |
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 $58.88 Median $131.83 Typical High $141.25 | Professional | None | $58.88 | $131.83 | $141.25 |
Health New England Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $489.78 | Facility | None | $128.82 | $147.91 | $489.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $60.26 Median $158.49 Typical High $912.01 | Professional | None | $60.26 | $158.49 | $912.01 |
United Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $177.83 | Facility | None | $75.86 | $87.10 | $177.83 |
United Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $151.36 | Professional | None | $51.29 | $77.62 | $151.36 |
Well Sense Setting Facility Modifier None Typical Low $120.23 Median $162.18 Typical High $239.88 | Facility | None | $120.23 | $162.18 | $239.88 |
Well Sense Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | None | $95.50 | $95.50 | $114.82 |
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 $33.88 Median $33.88 Typical High $154.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $61.66 | Professional | 53 · Discontinued | $13.49 | $13.49 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $46.77 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $30.90 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $30.90 |
Where Massachusetts sits
The same service costs 3.2 times more in Hawaii than in Florida. 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· 16th of 51
$105
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.