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 $28.18 Median $28.18 Typical High $128.82 | Facility | None | $28.18 | $28.18 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $128.82 | Professional | None | $28.18 | $28.18 | $128.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $199.53 | Facility | None | $60.26 | $61.66 | $199.53 |
AllWays Health Partners Setting Professional Modifier None Typical Low $26.92 Median $66.07 Typical High $338.84 | Professional | None | $26.92 | $66.07 | $338.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $50.12 | Professional | None | $44.67 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
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 $25.12 Median $54.95 Typical High $58.88 | Professional | None | $25.12 | $54.95 | $58.88 |
Health New England Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Mass General Brigham Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $199.53 | Facility | None | $60.26 | $61.66 | $199.53 |
Mass General Brigham Setting Professional Modifier None Typical Low $26.92 Median $66.07 Typical High $338.84 | Professional | None | $26.92 | $66.07 | $338.84 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $21.38 Median $32.36 Typical High $63.10 | Professional | None | $21.38 | $32.36 | $63.10 |
Well Sense Setting Facility Modifier None Typical Low $57.54 Median $77.62 Typical High $114.82 | Facility | None | $57.54 | $77.62 | $114.82 |
Well Sense Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | None | $41.69 | $41.69 | $50.12 |
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 $14.13 Median $14.13 Typical High $64.57 | Professional | 52 · Reduced service | $14.13 | $14.13 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $25.70 | Professional | 53 · Discontinued | $5.62 | $5.62 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $19.05 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $12.88 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $12.88 |
Where Massachusetts sits
The same service costs 2.6 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· 18th of 51
$50.12
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.