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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $21.88 | Professional | None | $20.42 | $20.42 | $21.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $26.92 Median $30.20 Typical High $234.42 | Facility | None | $26.92 | $30.20 | $234.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $17.78 Median $70.79 Typical High $229.09 | Professional | None | $17.78 | $70.79 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $56.23 | Professional | None | $39.81 | $39.81 | $56.23 |
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 $15.49 Median $41.69 Typical High $89.13 | Professional | None | $15.49 | $41.69 | $89.13 |
Health New England Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Mass General Brigham Setting Facility Modifier None Typical Low $26.92 Median $30.20 Typical High $234.42 | Facility | None | $26.92 | $30.20 | $234.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $17.78 Median $70.79 Typical High $229.09 | Professional | None | $17.78 | $70.79 | $229.09 |
United Setting Professional Modifier None Typical Low $15.49 Median $23.44 Typical High $41.69 | Professional | None | $15.49 | $23.44 | $41.69 |
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 $10.23 Median $10.23 Typical High $10.96 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.37 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.31 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.19 |
Where Massachusetts sits
The same service costs 8.9 times more in North Dakota 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· 23rd of 51
$38.90
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.