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 $83.18 Median $83.18 Typical High $380.19 | Facility | None | $83.18 | $83.18 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $380.19 | Professional | None | $83.18 | $83.18 | $380.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $588.84 | Facility | None | $125.89 | $177.83 | $588.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $74.13 Median $190.55 Typical High $1,000.00 | Professional | None | $74.13 | $190.55 | $1,000.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | None | $131.83 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $109.65 | Professional | None | $79.43 | $79.43 | $109.65 |
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 $72.44 Median $158.49 Typical High $169.82 | Professional | None | $72.44 | $158.49 | $169.82 |
Health New England Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $588.84 | Facility | None | $125.89 | $177.83 | $588.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $74.13 Median $190.55 Typical High $1,000.00 | Professional | None | $74.13 | $190.55 | $1,000.00 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $181.97 | Professional | None | $63.10 | $93.33 | $181.97 |
Well Sense Setting Facility Modifier None Typical Low $169.82 Median $229.09 Typical High $331.13 | Facility | None | $169.82 | $229.09 | $331.13 |
Well Sense Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | None | $123.03 | $123.03 | $147.91 |
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 $40.74 Median $40.74 Typical High $186.21 | Professional | 52 · Reduced service | $40.74 | $40.74 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $75.86 | Professional | 53 · Discontinued | $16.60 | $16.60 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $56.23 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $38.02 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $38.02 |
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
$141
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.