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 $22.39 Median $22.39 Typical High $102.33 | Facility | None | $22.39 | $22.39 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $102.33 | Professional | None | $22.39 | $22.39 | $102.33 |
AllWays Health Partners Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $158.49 | Facility | None | $47.86 | $47.86 | $158.49 |
AllWays Health Partners Setting Professional Modifier None Typical Low $20.89 Median $51.29 Typical High $269.15 | Professional | None | $20.89 | $51.29 | $269.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $38.90 | Professional | None | $35.48 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $37.15 | Professional | None | $26.30 | $26.30 | $37.15 |
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 $19.50 Median $43.65 Typical High $45.71 | Professional | None | $19.50 | $43.65 | $45.71 |
Health New England Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Mass General Brigham Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $158.49 | Facility | None | $47.86 | $47.86 | $158.49 |
Mass General Brigham Setting Professional Modifier None Typical Low $20.89 Median $51.29 Typical High $269.15 | Professional | None | $20.89 | $51.29 | $269.15 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.12 Typical High $50.12 | Professional | None | $16.98 | $25.12 | $50.12 |
Well Sense Setting Facility Modifier None Typical Low $45.71 Median $60.26 Typical High $89.13 | Facility | None | $45.71 | $60.26 | $89.13 |
Well Sense Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $39.81 | Professional | None | $33.11 | $33.11 | $39.81 |
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 $11.22 Median $11.22 Typical High $51.29 | Professional | 52 · Reduced service | $11.22 | $11.22 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $20.42 | Professional | 53 · Discontinued | $4.47 | $4.47 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $15.14 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $10.23 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $10.23 |
Where Massachusetts sits
The same service costs 2.1 times more in Montana than in Alabama. 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· 17th of 51
$38.90
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.