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 $33.11 Median $33.11 Typical High $151.36 | Facility | None | $33.11 | $33.11 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $151.36 | Professional | None | $33.11 | $33.11 | $151.36 |
AllWays Health Partners Setting Facility Modifier None Typical Low $64.57 Median $72.44 Typical High $239.88 | Facility | None | $64.57 | $72.44 | $239.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $31.62 Median $77.62 Typical High $398.11 | Professional | None | $31.62 | $77.62 | $398.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $85.11 Median $100.00 Typical High $131.83 | Facility | None | $85.11 | $100.00 | $131.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $58.88 | Professional | None | $53.70 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $44.67 | Professional | None | $31.62 | $31.62 | $44.67 |
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 $29.51 Median $64.57 Typical High $69.18 | Professional | None | $29.51 | $64.57 | $69.18 |
Health New England Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $64.57 Median $72.44 Typical High $239.88 | Facility | None | $64.57 | $72.44 | $239.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $31.62 Median $77.62 Typical High $398.11 | Professional | None | $31.62 | $77.62 | $398.11 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $74.13 | Professional | None | $25.12 | $38.02 | $74.13 |
Well Sense Setting Facility Modifier None Typical Low $67.61 Median $91.20 Typical High $134.90 | Facility | None | $67.61 | $91.20 | $134.90 |
Well Sense Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | None | $50.12 | $50.12 | $60.26 |
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 $16.60 Median $16.60 Typical High $75.86 | Professional | 52 · Reduced service | $16.60 | $16.60 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $30.20 | Professional | 53 · Discontinued | $6.61 | $6.61 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $22.91 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $15.14 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $15.14 |
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
$58.88
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.