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 $44.67 Median $44.67 Typical High $204.17 | Facility | None | $44.67 | $44.67 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $204.17 | Professional | None | $44.67 | $44.67 | $204.17 |
AllWays Health Partners Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $323.59 | Facility | None | $81.28 | $91.20 | $323.59 |
AllWays Health Partners Setting Professional Modifier None Typical Low $38.02 Median $104.71 Typical High $575.44 | Professional | None | $38.02 | $104.71 | $575.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $102.33 Median $131.83 Typical High $177.83 | Facility | None | $102.33 | $131.83 | $177.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | None | $66.07 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Facility | None | $54.95 | $54.95 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
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 $34.67 Median $87.10 Typical High $93.33 | Professional | None | $34.67 | $87.10 | $93.33 |
Health New England Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Mass General Brigham Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $323.59 | Facility | None | $81.28 | $91.20 | $323.59 |
Mass General Brigham Setting Professional Modifier None Typical Low $38.02 Median $104.71 Typical High $575.44 | Professional | None | $38.02 | $104.71 | $575.44 |
United Setting Facility Modifier None Typical Low $51.29 Median $104.71 Typical High $104.71 | Facility | None | $51.29 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $97.72 | Professional | None | $33.88 | $50.12 | $97.72 |
Well Sense Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $177.83 | Facility | None | $91.20 | $120.23 | $177.83 |
Well Sense Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | None | $66.07 | $66.07 | $79.43 |
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 $22.39 Median $22.39 Typical High $102.33 | Professional | 52 · Reduced service | $22.39 | $22.39 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $40.74 | Professional | 53 · Discontinued | $8.91 | $8.91 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $30.20 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $20.42 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $20.42 |
Where Massachusetts sits
The same service costs 3.5 times more in Hawaii than in West Virginia. 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· 12th of 51
$69.18
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.