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 $38.02 Median $38.02 Typical High $173.78 | Facility | None | $38.02 | $38.02 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $173.78 | Professional | None | $38.02 | $38.02 | $173.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $69.18 Median $83.18 Typical High $269.15 | Facility | None | $69.18 | $83.18 | $269.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.88 Median $89.13 Typical High $457.09 | Professional | None | $33.88 | $89.13 | $457.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $97.72 Median $112.20 Typical High $151.36 | Facility | None | $97.72 | $112.20 | $151.36 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | None | $58.88 | $58.88 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
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 $33.88 Median $74.13 Typical High $79.43 | Professional | None | $33.88 | $74.13 | $79.43 |
Health New England Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $93.33 | Professional | None | $20.89 | $20.89 | $93.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $69.18 Median $83.18 Typical High $269.15 | Facility | None | $69.18 | $83.18 | $269.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.88 Median $89.13 Typical High $457.09 | Professional | None | $33.88 | $89.13 | $457.09 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $28.84 Median $43.65 Typical High $85.11 | Professional | None | $28.84 | $43.65 | $85.11 |
Well Sense Setting Facility Modifier None Typical Low $77.62 Median $104.71 Typical High $154.88 | Facility | None | $77.62 | $104.71 | $154.88 |
Well Sense Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | None | $56.23 | $56.23 | $67.61 |
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 $19.05 Median $19.05 Typical High $87.10 | Professional | 52 · Reduced service | $19.05 | $19.05 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $34.67 | Professional | 53 · Discontinued | $7.59 | $7.59 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $25.70 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $17.38 |
Where Massachusetts sits
The same service costs 3.0 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· 19th of 51
$60.26
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.