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 $123.03 Median $131.83 Typical High $426.58 | Facility | None | $123.03 | $131.83 | $426.58 |
AllWays Health Partners Setting Professional Modifier None Typical Low $57.54 Median $138.04 Typical High $851.14 | Professional | None | $57.54 | $138.04 | $851.14 |
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 $114.82 Typical High $114.82 | Professional | None | $89.13 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $104.71 Typical High $104.71 | Facility | None | $79.43 | $104.71 | $104.71 |
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 $53.70 Median $114.82 Typical High $123.03 | Professional | None | $53.70 | $114.82 | $123.03 |
Health New England Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $123.03 Median $131.83 Typical High $426.58 | Facility | None | $123.03 | $131.83 | $426.58 |
Mass General Brigham Setting Professional Modifier None Typical Low $57.54 Median $138.04 Typical High $851.14 | Professional | None | $57.54 | $138.04 | $851.14 |
United Setting Facility Modifier None Typical Low $75.86 Median $85.11 Typical High $173.78 | Facility | None | $75.86 | $85.11 | $173.78 |
United Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $131.83 | Professional | None | $45.71 | $67.61 | $131.83 |
Well Sense Setting Facility Modifier None Typical Low $123.03 Median $165.96 Typical High $239.88 | Facility | None | $123.03 | $165.96 | $239.88 |
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 $29.51 Median $29.51 Typical High $134.90 | Professional | 52 · Reduced service | $29.51 | $29.51 | $134.90 |
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 $8.91 Median $8.91 Typical High $40.74 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $40.74 |
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 3.0 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· 15th 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.