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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | None | $34.67 | $34.67 | $37.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $281.84 | Facility | None | $45.71 | $45.71 | $281.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $26.30 Median $60.26 Typical High $389.05 | Professional | None | $26.30 | $60.26 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
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 $26.30 Median $69.18 Typical High $104.71 | Professional | None | $26.30 | $69.18 | $104.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $281.84 | Facility | None | $45.71 | $45.71 | $281.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $26.30 Median $60.26 Typical High $389.05 | Professional | None | $26.30 | $60.26 | $389.05 |
United Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $69.18 | Professional | None | $26.30 | $38.90 | $69.18 |
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 $17.38 Median $17.38 Typical High $18.62 | Professional | 52 · Reduced service | $17.38 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $7.41 | Professional | 53 · Discontinued | $6.92 | $6.92 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $5.62 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $3.72 |
Where Massachusetts sits
The same service costs 4.1 times more in Kansas 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· 24th of 51
$47.86
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.