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 $38.90 Median $38.90 Typical High $177.83 | Facility | None | $38.90 | $38.90 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $177.83 | Professional | None | $38.90 | $38.90 | $177.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $281.84 | Facility | None | $83.18 | $85.11 | $281.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $37.15 Median $91.20 Typical High $467.74 | Professional | None | $37.15 | $91.20 | $467.74 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $69.18 | Professional | None | $58.88 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $52.48 | Professional | None | $37.15 | $37.15 | $52.48 |
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 $34.67 Median $75.86 Typical High $81.28 | Professional | None | $34.67 | $75.86 | $81.28 |
Health New England Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Mass General Brigham Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $281.84 | Facility | None | $83.18 | $85.11 | $281.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $37.15 Median $91.20 Typical High $467.74 | Professional | None | $37.15 | $91.20 | $467.74 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $29.51 Median $44.67 Typical High $87.10 | Professional | None | $29.51 | $44.67 | $87.10 |
Well Sense Setting Facility Modifier None Typical Low $79.43 Median $107.15 Typical High $158.49 | Facility | None | $79.43 | $107.15 | $158.49 |
Well Sense Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | None | $58.88 | $58.88 | $70.79 |
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 $19.50 Median $19.50 Typical High $89.13 | Professional | 52 · Reduced service | $19.50 | $19.50 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $35.48 | Professional | 53 · Discontinued | $7.76 | $7.76 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $26.92 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $17.78 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $17.78 |
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
$69.18
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.