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 $21.38 Median $21.38 Typical High $97.72 | Facility | None | $21.38 | $21.38 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $97.72 | Professional | None | $21.38 | $21.38 | $97.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $46.77 Typical High $154.88 | Facility | None | $45.71 | $46.77 | $154.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $20.42 Median $50.12 Typical High $257.04 | Professional | None | $20.42 | $50.12 | $257.04 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $38.02 | Professional | None | $34.67 | $38.02 | $38.02 |
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 $34.67 | Professional | None | $24.55 | $24.55 | $34.67 |
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 $19.05 Median $41.69 Typical High $44.67 | Professional | None | $19.05 | $41.69 | $44.67 |
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 $45.71 Median $46.77 Typical High $154.88 | Facility | None | $45.71 | $46.77 | $154.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $20.42 Median $50.12 Typical High $257.04 | Professional | None | $20.42 | $50.12 | $257.04 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $16.60 Median $24.55 Typical High $47.86 | Professional | None | $16.60 | $24.55 | $47.86 |
Well Sense Setting Facility Modifier None Typical Low $43.65 Median $60.26 Typical High $87.10 | Facility | None | $43.65 | $60.26 | $87.10 |
Well Sense Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.90 | Professional | None | $32.36 | $32.36 | $38.90 |
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 $10.72 Median $10.72 Typical High $48.98 | Professional | 52 · Reduced service | $10.72 | $10.72 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $19.50 | Professional | 53 · Discontinued | $4.27 | $4.27 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $14.79 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $9.77 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $9.77 |
Where Massachusetts sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$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.