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 $41.69 Median $41.69 Typical High $190.55 | Facility | None | $41.69 | $41.69 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $190.55 | Professional | None | $41.69 | $41.69 | $190.55 |
AllWays Health Partners Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $302.00 | Facility | None | $89.13 | $91.20 | $302.00 |
AllWays Health Partners Setting Professional Modifier None Typical Low $39.81 Median $97.72 Typical High $501.19 | Professional | None | $39.81 | $97.72 | $501.19 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $74.13 | Professional | None | $67.61 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | None | $48.98 | $48.98 | $67.61 |
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 $37.15 Median $81.28 Typical High $87.10 | Professional | None | $37.15 | $81.28 | $87.10 |
Health New England Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $302.00 | Facility | None | $89.13 | $91.20 | $302.00 |
Mass General Brigham Setting Professional Modifier None Typical Low $39.81 Median $97.72 Typical High $501.19 | Professional | None | $39.81 | $97.72 | $501.19 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $93.33 | Professional | None | $31.62 | $47.86 | $93.33 |
Well Sense Setting Facility Modifier None Typical Low $85.11 Median $114.82 Typical High $169.82 | Facility | None | $85.11 | $114.82 | $169.82 |
Well Sense Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | None | $61.66 | $61.66 | $74.13 |
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 $20.89 Median $20.89 Typical High $95.50 | Professional | 52 · Reduced service | $20.89 | $20.89 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $38.02 | Professional | 53 · Discontinued | $8.32 | $8.32 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $28.84 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $19.05 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $19.05 |
Where Massachusetts sits
The same service costs 2.0 times more in Montana than in Vermont. 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· 20th of 51
$72.44
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.