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 $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
AllWays Health Partners Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $295.12 | Facility | None | $104.71 | $107.15 | $295.12 |
AllWays Health Partners Setting Professional Modifier None Typical Low $48.98 Median $114.82 Typical High $588.84 | Professional | None | $48.98 | $114.82 | $588.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $151.36 | Facility | None | $50.12 | $50.12 | $151.36 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | None | $72.44 | $72.44 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $72.44 | Professional | None | $51.29 | $51.29 | $72.44 |
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 $44.67 Median $95.50 Typical High $102.33 | Professional | None | $44.67 | $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 $104.71 Median $107.15 Typical High $295.12 | Facility | None | $104.71 | $107.15 | $295.12 |
Mass General Brigham Setting Professional Modifier None Typical Low $48.98 Median $114.82 Typical High $588.84 | Professional | None | $48.98 | $114.82 | $588.84 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $141.25 | Facility | None | $57.54 | $63.10 | $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 $117.49 Typical High $173.78 | Facility | None | $89.13 | $117.49 | $173.78 |
Well Sense Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | None | $53.70 | $53.70 | $64.57 |
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 $33.11 | Professional | 52 · Reduced service | $24.55 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $12.02 | Professional | 53 · Discontinued | $9.77 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $10.00 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $6.61 |
Where Massachusetts sits
The same service costs 2.4 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· 19th of 51
$77.62
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.