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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $15.85 | Professional | None | $14.79 | $14.79 | $15.85 |
AllWays Health Partners Setting Facility Modifier None Typical Low $19.50 Median $21.88 Typical High $141.25 | Facility | None | $19.50 | $21.88 | $141.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $12.88 Median $39.81 Typical High $169.82 | Professional | None | $12.88 | $39.81 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
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 $11.22 Median $30.20 Typical High $52.48 | Professional | None | $11.22 | $30.20 | $52.48 |
Mass General Brigham Setting Facility Modifier None Typical Low $19.50 Median $21.88 Typical High $141.25 | Facility | None | $19.50 | $21.88 | $141.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $12.88 Median $39.81 Typical High $169.82 | Professional | None | $12.88 | $39.81 | $169.82 |
United Setting Professional Modifier None Typical Low $11.22 Median $16.60 Typical High $30.20 | Professional | None | $11.22 | $16.60 | $30.20 |
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 $7.41 Median $7.41 Typical High $7.94 | Professional | 52 · Reduced service | $7.41 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $3.16 | Professional | 53 · Discontinued | $2.95 | $2.95 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.40 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $1.58 |
Where Massachusetts sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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· 13th of 51
$25.70
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.