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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $20.89 | Professional | None | $19.50 | $19.50 | $20.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $25.70 Median $28.18 Typical High $251.19 | Facility | None | $25.70 | $28.18 | $251.19 |
AllWays Health Partners Setting Professional Modifier None Typical Low $16.60 Median $30.20 Typical High $213.80 | Professional | None | $16.60 | $30.20 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | None | $20.89 | $20.89 | $28.84 |
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 $38.90 Typical High $93.33 | Professional | None | $14.45 | $38.90 | $93.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $25.70 Median $28.18 Typical High $251.19 | Facility | None | $25.70 | $28.18 | $251.19 |
Mass General Brigham Setting Professional Modifier None Typical Low $16.60 Median $30.20 Typical High $213.80 | Professional | None | $16.60 | $30.20 | $213.80 |
United Setting Professional Modifier None Typical Low $14.45 Median $21.88 Typical High $38.90 | Professional | None | $14.45 | $21.88 | $38.90 |
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 $9.77 Median $9.77 Typical High $10.47 | Professional | 52 · Reduced service | $9.77 | $9.77 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $4.17 | Professional | 53 · Discontinued | $3.89 | $3.89 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $3.09 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.09 |
Where Massachusetts sits
The same service costs 4.1 times more in Wyoming than in Utah. 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· 9th of 51
$30.20
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.