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 $36.31 Median $36.31 Typical High $165.96 | Facility | None | $36.31 | $36.31 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $165.96 | Professional | None | $36.31 | $36.31 | $165.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $70.79 Median $79.43 Typical High $263.03 | Facility | None | $70.79 | $79.43 | $263.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.11 Median $85.11 Typical High $501.19 | Professional | None | $33.11 | $85.11 | $501.19 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $147.91 | Facility | None | $48.98 | $48.98 | $147.91 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | None | $54.95 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Facility | None | $56.23 | $56.23 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $74.13 | Professional | None | $40.74 | $40.74 | $74.13 |
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 $30.20 Median $70.79 Typical High $75.86 | Professional | None | $30.20 | $70.79 | $75.86 |
Health New England Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $70.79 Median $79.43 Typical High $263.03 | Facility | None | $70.79 | $79.43 | $263.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.11 Median $85.11 Typical High $501.19 | Professional | None | $33.11 | $85.11 | $501.19 |
United Setting Facility Modifier None Typical Low $43.65 Median $89.13 Typical High $89.13 | Facility | None | $43.65 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $28.18 Median $41.69 Typical High $81.28 | Professional | None | $28.18 | $41.69 | $81.28 |
Well Sense Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $147.91 | Facility | None | $75.86 | $100.00 | $147.91 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | None | $54.95 | $54.95 | $66.07 |
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 $18.20 Median $18.20 Typical High $83.18 | Professional | 52 · Reduced service | $18.20 | $18.20 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $33.88 | Professional | 53 · Discontinued | $7.41 | $7.41 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $25.12 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $16.60 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $16.60 |
Where Massachusetts sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 16th of 51
$56.23
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.