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 $20.89 Median $20.89 Typical High $95.50 | Facility | None | $20.89 | $20.89 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $95.50 | Professional | None | $20.89 | $20.89 | $95.50 |
AllWays Health Partners Setting Facility Modifier None Typical Low $44.67 Median $45.71 Typical High $147.91 | Facility | None | $44.67 | $45.71 | $147.91 |
AllWays Health Partners Setting Professional Modifier None Typical Low $19.95 Median $48.98 Typical High $251.19 | Professional | None | $19.95 | $48.98 | $251.19 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $33.88 Median $37.15 Typical High $37.15 | Professional | None | $33.88 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
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 $18.62 Median $40.74 Typical High $43.65 | Professional | None | $18.62 | $40.74 | $43.65 |
Health New England Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $44.67 Median $45.71 Typical High $147.91 | Facility | None | $44.67 | $45.71 | $147.91 |
Mass General Brigham Setting Professional Modifier None Typical Low $19.95 Median $48.98 Typical High $251.19 | Professional | None | $19.95 | $48.98 | $251.19 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $15.85 Median $23.99 Typical High $46.77 | Professional | None | $15.85 | $23.99 | $46.77 |
Well Sense Setting Facility Modifier None Typical Low $42.66 Median $57.54 Typical High $85.11 | Facility | None | $42.66 | $57.54 | $85.11 |
Well Sense Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $37.15 | Professional | None | $30.90 | $30.90 | $37.15 |
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 $10.47 Median $10.47 Typical High $47.86 | Professional | 52 · Reduced service | $10.47 | $10.47 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $19.05 | Professional | 53 · Discontinued | $4.17 | $4.17 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $14.45 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $9.55 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $9.55 |
Where Massachusetts sits
The same service costs 3.1 times more in Montana 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· 17th of 51
$37.15
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.