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 $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $19.50 | Professional | None | $18.20 | $18.20 | $19.50 |
AllWays Health Partners Setting Facility Modifier None Typical Low $12.02 Median $23.99 Typical High $204.17 | Facility | None | $12.02 | $23.99 | $204.17 |
AllWays Health Partners Setting Professional Modifier None Typical Low $12.02 Median $20.42 Typical High $204.17 | Professional | None | $12.02 | $20.42 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $28.18 | Professional | None | $19.95 | $19.95 | $28.18 |
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 $13.80 Median $36.31 Typical High $75.86 | Professional | None | $13.80 | $36.31 | $75.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $12.02 Median $23.99 Typical High $204.17 | Facility | None | $12.02 | $23.99 | $204.17 |
Mass General Brigham Setting Professional Modifier None Typical Low $12.02 Median $20.42 Typical High $204.17 | Professional | None | $12.02 | $20.42 | $204.17 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.42 Typical High $36.31 | Professional | None | $13.80 | $20.42 | $36.31 |
Well Sense Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
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 $9.12 Median $9.12 Typical High $9.77 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.89 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.95 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.95 |
Where Massachusetts sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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· 31st of 51
$20.42
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.