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 $74.13 Median $74.13 Typical High $338.84 | Facility | None | $74.13 | $74.13 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $338.84 | Professional | None | $74.13 | $74.13 | $338.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $478.63 | Facility | None | $158.49 | $162.18 | $478.63 |
AllWays Health Partners Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $891.25 | Professional | None | $69.18 | $173.78 | $891.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $141.25 | Professional | None | $109.65 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $117.49 | Facility | None | $66.07 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
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 $64.57 Median $144.54 Typical High $151.36 | Professional | None | $64.57 | $144.54 | $151.36 |
Health New England Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $478.63 | Facility | None | $158.49 | $162.18 | $478.63 |
Mass General Brigham Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $891.25 | Professional | None | $69.18 | $173.78 | $891.25 |
United Setting Facility Modifier None Typical Low $57.54 Median $208.93 Typical High $208.93 | Facility | None | $57.54 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $56.23 Median $83.18 Typical High $165.96 | Professional | None | $56.23 | $83.18 | $165.96 |
Well Sense Setting Facility Modifier None Typical Low $151.36 Median $204.17 Typical High $295.12 | Facility | None | $151.36 | $204.17 | $295.12 |
Well Sense Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | None | $109.65 | $109.65 | $131.83 |
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 $37.15 Median $37.15 Typical High $169.82 | Professional | 52 · Reduced service | $37.15 | $37.15 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $67.61 | Professional | 53 · Discontinued | $14.79 | $14.79 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $50.12 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $33.88 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $33.88 |
Where Massachusetts sits
The same service costs 2.1 times more in Montana 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· 17th of 51
$129
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.