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 $19.50 Median $19.50 Typical High $89.13 | Facility | None | $19.50 | $19.50 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $89.13 | Professional | None | $19.50 | $19.50 | $89.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $41.69 Median $42.66 Typical High $141.25 | Facility | None | $41.69 | $42.66 | $141.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $18.62 Median $45.71 Typical High $234.42 | Professional | None | $18.62 | $45.71 | $234.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $34.67 | Professional | None | $31.62 | $34.67 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
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 $17.38 Median $38.02 Typical High $40.74 | Professional | None | $17.38 | $38.02 | $40.74 |
Health New England Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Mass General Brigham Setting Facility Modifier None Typical Low $41.69 Median $42.66 Typical High $141.25 | Facility | None | $41.69 | $42.66 | $141.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $18.62 Median $45.71 Typical High $234.42 | Professional | None | $18.62 | $45.71 | $234.42 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $14.79 Median $22.39 Typical High $43.65 | Professional | None | $14.79 | $22.39 | $43.65 |
Well Sense Setting Facility Modifier None Typical Low $39.81 Median $53.70 Typical High $79.43 | Facility | None | $39.81 | $53.70 | $79.43 |
Well Sense Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | None | $29.51 | $29.51 | $35.48 |
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 $9.77 Median $9.77 Typical High $44.67 | Professional | 52 · Reduced service | $9.77 | $9.77 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $17.78 | Professional | 53 · Discontinued | $3.89 | $3.89 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $13.49 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $8.91 |
Where Massachusetts sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 17th of 51
$33.88
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.