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 $51.29 Median $51.29 Typical High $234.42 | Facility | None | $51.29 | $51.29 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $234.42 | Professional | None | $51.29 | $51.29 | $234.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $104.71 Median $112.20 Typical High $371.54 | Facility | None | $104.71 | $112.20 | $371.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $46.77 Median $120.23 Typical High $691.83 | Professional | None | $46.77 | $120.23 | $691.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $208.93 | Facility | None | $69.18 | $69.18 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $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 $45.71 Median $100.00 Typical High $107.15 | Professional | None | $45.71 | $100.00 | $107.15 |
Health New England Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $104.71 Median $112.20 Typical High $371.54 | Facility | None | $104.71 | $112.20 | $371.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $46.77 Median $120.23 Typical High $691.83 | Professional | None | $46.77 | $120.23 | $691.83 |
United Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $138.04 | Facility | None | $46.77 | $61.66 | $138.04 |
United Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $114.82 | Professional | None | $39.81 | $58.88 | $114.82 |
Well Sense Setting Facility Modifier None Typical Low $104.71 Median $141.25 Typical High $208.93 | Facility | None | $104.71 | $141.25 | $208.93 |
Well Sense Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | None | $77.62 | $77.62 | $93.33 |
5 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 $25.70 Median $25.70 Typical High $117.49 | Professional | 52 · Reduced service | $25.70 | $25.70 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $46.77 | Professional | 53 · Discontinued | $10.23 | $10.23 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $35.48 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $23.44 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $23.44 |
BCBS Massachusetts Setting Professional Modifier RA · Replacement item Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | RA · Replacement item | $77.62 | $91.20 | $91.20 |
Where Massachusetts sits
The same service costs 2.7 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· 16th of 51
$85.11
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.