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 $17.78 Median $17.78 Typical High $81.28 | Facility | None | $17.78 | $17.78 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $81.28 | Professional | None | $17.78 | $17.78 | $81.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $125.89 | Facility | None | $38.02 | $38.02 | $125.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $16.60 Median $40.74 Typical High $213.80 | Professional | None | $16.60 | $40.74 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $23.44 | Professional | None | $16.98 | $16.98 | $23.44 |
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 $15.49 Median $34.67 Typical High $36.31 | Professional | None | $15.49 | $34.67 | $36.31 |
Health New England Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $125.89 | Facility | None | $38.02 | $38.02 | $125.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $16.60 Median $40.74 Typical High $213.80 | Professional | None | $16.60 | $40.74 | $213.80 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $13.49 Median $19.95 Typical High $39.81 | Professional | None | $13.49 | $19.95 | $39.81 |
Well Sense Setting Facility Modifier None Typical Low $36.31 Median $47.86 Typical High $70.79 | Facility | None | $36.31 | $47.86 | $70.79 |
Well Sense Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | None | $26.30 | $26.30 | $31.62 |
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 $8.91 Median $8.91 Typical High $40.74 | Professional | 52 · Reduced service | $8.91 | $8.91 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $16.22 | Professional | 53 · Discontinued | $3.55 | $3.55 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $12.02 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $8.13 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $8.13 |
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
$31.62
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.