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 $57.54 Median $57.54 Typical High $263.03 | Facility | None | $57.54 | $57.54 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $263.03 | Professional | None | $57.54 | $57.54 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $407.38 | Facility | None | $97.72 | $125.89 | $407.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $48.98 Median $134.90 Typical High $575.44 | Professional | None | $48.98 | $134.90 | $575.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $229.09 | Facility | None | $75.86 | $75.86 | $229.09 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | None | $85.11 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $75.86 | Facility | None | $61.66 | $61.66 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
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 $44.67 Median $112.20 Typical High $120.23 | Professional | None | $44.67 | $112.20 | $120.23 |
Health New England Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $407.38 | Facility | None | $97.72 | $125.89 | $407.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $48.98 Median $134.90 Typical High $575.44 | Professional | None | $48.98 | $134.90 | $575.44 |
United Setting Facility Modifier None Typical Low $29.51 Median $48.98 Typical High $134.90 | Facility | None | $29.51 | $48.98 | $134.90 |
United Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $125.89 | Professional | None | $43.65 | $66.07 | $125.89 |
Well Sense Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $204.17 | Facility | None | $102.33 | $134.90 | $204.17 |
Well Sense Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | None | $81.28 | $81.28 | $97.72 |
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 $28.84 Median $28.84 Typical High $131.83 | Professional | 52 · Reduced service | $28.84 | $28.84 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $52.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $38.90 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $26.30 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $26.30 |
Where Massachusetts sits
The same service costs 2.4 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· 11th of 51
$89.13
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.