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 $61.66 Median $61.66 Typical High $281.84 | Facility | None | $61.66 | $61.66 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $281.84 | Professional | None | $61.66 | $61.66 | $281.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $117.49 Median $134.90 Typical High $436.52 | Facility | None | $117.49 | $134.90 | $436.52 |
AllWays Health Partners Setting Professional Modifier None Typical Low $52.48 Median $144.54 Typical High $912.01 | Professional | None | $52.48 | $144.54 | $912.01 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $245.47 | Facility | None | $81.28 | $81.28 | $245.47 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $117.49 | Professional | None | $93.33 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $81.28 | Facility | None | $69.18 | $69.18 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
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 $47.86 Median $120.23 Typical High $128.82 | Professional | None | $47.86 | $120.23 | $128.82 |
Health New England Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $117.49 Median $134.90 Typical High $436.52 | Facility | None | $117.49 | $134.90 | $436.52 |
Mass General Brigham Setting Professional Modifier None Typical Low $52.48 Median $144.54 Typical High $912.01 | Professional | None | $52.48 | $144.54 | $912.01 |
United Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $144.54 | Facility | None | $70.79 | $83.18 | $144.54 |
United Setting Professional Modifier None Typical Low $46.77 Median $70.79 Typical High $134.90 | Professional | None | $46.77 | $70.79 | $134.90 |
Well Sense Setting Facility Modifier None Typical Low $125.89 Median $165.96 Typical High $251.19 | Facility | None | $125.89 | $165.96 | $251.19 |
Well Sense Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | None | $91.20 | $91.20 | $109.65 |
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 $30.90 Median $30.90 Typical High $141.25 | Professional | 52 · Reduced service | $30.90 | $30.90 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $56.23 | Professional | 53 · Discontinued | $12.30 | $12.30 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $42.66 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $28.18 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $28.18 |
Where Massachusetts sits
The same service costs 4.4 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· 10th of 51
$100
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.