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 $144.54 Median $144.54 Typical High $489.78 | Facility | None | $144.54 | $144.54 | $489.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $63.10 Median $158.49 Typical High $812.83 | Professional | None | $63.10 | $158.49 | $812.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | None | $100.00 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $97.72 | Facility | None | $89.13 | $89.13 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
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 $60.26 Median $131.83 Typical High $138.04 | Professional | None | $60.26 | $131.83 | $138.04 |
Health New England Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Mass General Brigham Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $489.78 | Facility | None | $144.54 | $144.54 | $489.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $63.10 Median $158.49 Typical High $812.83 | Professional | None | $63.10 | $158.49 | $812.83 |
United Setting Facility Modifier None Typical Low $77.62 Median $190.55 Typical High $190.55 | Facility | None | $77.62 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $151.36 | Professional | None | $51.29 | $75.86 | $151.36 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $269.15 | Facility | None | $138.04 | $186.21 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | None | $100.00 | $100.00 | $120.23 |
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 $10.00 Median $10.00 Typical High $45.71 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $45.71 |
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 2.8 times more in Kansas 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· 18th of 51
$120
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.