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 $45.71 Median $45.71 Typical High $208.93 | Facility | None | $45.71 | $45.71 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $208.93 | Professional | None | $45.71 | $45.71 | $208.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $323.59 | Facility | None | $95.50 | $109.65 | $323.59 |
AllWays Health Partners Setting Professional Modifier None Typical Low $44.67 Median $107.15 Typical High $707.95 | Professional | None | $44.67 | $107.15 | $707.95 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $218.78 | Facility | None | $128.82 | $162.18 | $218.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | None | $69.18 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $66.07 Typical High $74.13 | Facility | None | $60.26 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | None | $48.98 | $48.98 | $67.61 |
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 $40.74 Median $89.13 Typical High $95.50 | Professional | None | $40.74 | $89.13 | $95.50 |
Health New England Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $323.59 | Facility | None | $95.50 | $109.65 | $323.59 |
Mass General Brigham Setting Professional Modifier None Typical Low $44.67 Median $107.15 Typical High $707.95 | Professional | None | $44.67 | $107.15 | $707.95 |
United Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $141.25 | Facility | None | $61.66 | $69.18 | $141.25 |
United Setting Professional Modifier None Typical Low $34.67 Median $52.48 Typical High $100.00 | Professional | None | $34.67 | $52.48 | $100.00 |
Well Sense Setting Facility Modifier None Typical Low $81.28 Median $107.15 Typical High $162.18 | Facility | None | $81.28 | $107.15 | $162.18 |
Well Sense Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | None | $64.57 | $64.57 | $77.62 |
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 $22.91 Median $22.91 Typical High $104.71 | Professional | 52 · Reduced service | $22.91 | $22.91 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $41.69 | Professional | 53 · Discontinued | $9.12 | $9.12 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $31.62 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $20.89 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $20.89 |
Where Massachusetts sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 22nd of 51
$74.13
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.