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 $60.26 Median $60.26 Typical High $275.42 | Facility | None | $60.26 | $60.26 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $275.42 | Professional | None | $60.26 | $60.26 | $275.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $426.58 | Facility | None | $100.00 | $131.83 | $426.58 |
AllWays Health Partners Setting Professional Modifier None Typical Low $51.29 Median $141.25 Typical High $645.65 | Professional | None | $51.29 | $141.25 | $645.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $239.88 | Facility | None | $79.43 | $79.43 | $239.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | None | $89.13 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $79.43 | Facility | None | $64.57 | $64.57 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $66.07 | Professional | None | $46.77 | $46.77 | $66.07 |
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 $46.77 Median $117.49 Typical High $125.89 | Professional | None | $46.77 | $117.49 | $125.89 |
Health New England Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $426.58 | Facility | None | $100.00 | $131.83 | $426.58 |
Mass General Brigham Setting Professional Modifier None Typical Low $51.29 Median $141.25 Typical High $645.65 | Professional | None | $51.29 | $141.25 | $645.65 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $141.25 | Facility | None | $50.12 | $60.26 | $141.25 |
United Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $131.83 | Professional | None | $45.71 | $69.18 | $131.83 |
Well Sense Setting Facility Modifier None Typical Low $123.03 Median $162.18 Typical High $245.47 | Facility | None | $123.03 | $162.18 | $245.47 |
Well Sense Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | None | $89.13 | $89.13 | $107.15 |
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 $30.20 Median $30.20 Typical High $138.04 | Professional | 52 · Reduced service | $30.20 | $30.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $54.95 | Professional | 53 · Discontinued | $12.02 | $12.02 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $41.69 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $27.54 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $27.54 |
Where Massachusetts sits
The same service costs 2.8 times more in Wisconsin 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· 14th of 51
$97.72
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.