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 $16.22 Median $16.22 Typical High $74.13 | Facility | None | $16.22 | $16.22 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $74.13 | Professional | None | $16.22 | $16.22 | $74.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $34.67 Median $35.48 Typical High $117.49 | Facility | None | $34.67 | $35.48 | $117.49 |
AllWays Health Partners Setting Professional Modifier None Typical Low $15.49 Median $38.02 Typical High $194.98 | Professional | None | $15.49 | $38.02 | $194.98 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $41.69 Median $48.98 Typical High $64.57 | Facility | None | $41.69 | $48.98 | $64.57 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $26.30 | Professional | None | $25.12 | $25.12 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $21.88 | Professional | None | $15.49 | $15.49 | $21.88 |
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 $14.45 Median $31.62 Typical High $33.88 | Professional | None | $14.45 | $31.62 | $33.88 |
Health New England Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Mass General Brigham Setting Facility Modifier None Typical Low $34.67 Median $35.48 Typical High $117.49 | Facility | None | $34.67 | $35.48 | $117.49 |
Mass General Brigham Setting Professional Modifier None Typical Low $15.49 Median $38.02 Typical High $194.98 | Professional | None | $15.49 | $38.02 | $194.98 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $12.30 Median $18.62 Typical High $36.31 | Professional | None | $12.30 | $18.62 | $36.31 |
Well Sense Setting Facility Modifier None Typical Low $28.84 Median $38.90 Typical High $57.54 | Facility | None | $28.84 | $38.90 | $57.54 |
Well Sense Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $27.54 | Professional | None | $22.91 | $22.91 | $27.54 |
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 $8.13 Median $8.13 Typical High $37.15 | Professional | 52 · Reduced service | $8.13 | $8.13 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $14.79 | Professional | 53 · Discontinued | $3.24 | $3.24 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $11.22 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $7.41 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $7.41 |
Where Massachusetts sits
The same service costs 2.9 times more in Montana than in Kansas. 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
$26.30
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.