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 $48.98 Median $48.98 Typical High $223.87 | Facility | None | $48.98 | $48.98 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $223.87 | Professional | None | $48.98 | $48.98 | $223.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $95.50 Median $107.15 Typical High $275.42 | Facility | None | $95.50 | $107.15 | $275.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $46.77 Median $114.82 Typical High $588.84 | Professional | None | $46.77 | $114.82 | $588.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | None | $74.13 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $66.07 | Professional | None | $46.77 | $46.77 | $66.07 |
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 $43.65 Median $95.50 Typical High $102.33 | Professional | None | $43.65 | $95.50 | $102.33 |
Health New England Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $95.50 Median $107.15 Typical High $275.42 | Facility | None | $95.50 | $107.15 | $275.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $46.77 Median $114.82 Typical High $588.84 | Professional | None | $46.77 | $114.82 | $588.84 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
United Setting Professional Modifier None Typical Low $38.02 Median $56.23 Typical High $109.65 | Professional | None | $38.02 | $56.23 | $109.65 |
Well Sense Setting Facility Modifier None Typical Low $89.13 Median $120.23 Typical High $173.78 | Facility | None | $89.13 | $120.23 | $173.78 |
Well Sense Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | None | $69.18 | $69.18 | $83.18 |
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 $24.55 Median $24.55 Typical High $112.20 | Professional | 52 · Reduced service | $24.55 | $24.55 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $44.67 | Professional | 53 · Discontinued | $9.77 | $9.77 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $33.88 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $22.39 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $22.39 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii 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
$79.43
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.