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 $41.69 Median $41.69 Typical High $190.55 | Facility | None | $41.69 | $41.69 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $190.55 | Professional | None | $41.69 | $41.69 | $190.55 |
AllWays Health Partners Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $302.00 | Facility | None | $85.11 | $91.20 | $302.00 |
AllWays Health Partners Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $467.74 | Professional | None | $38.02 | $97.72 | $467.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $95.50 Median $123.03 Typical High $165.96 | Facility | None | $95.50 | $123.03 | $165.96 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $64.57 | Professional | None | $56.23 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $56.23 Typical High $64.57 | Facility | None | $54.95 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
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 $37.15 Median $81.28 Typical High $87.10 | Professional | None | $37.15 | $81.28 | $87.10 |
Health New England Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | None | $51.29 | $54.95 | $54.95 |
Mass General Brigham Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $302.00 | Facility | None | $85.11 | $91.20 | $302.00 |
Mass General Brigham Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $467.74 | Professional | None | $38.02 | $97.72 | $467.74 |
United Setting Facility Modifier None Typical Low $44.67 Median $112.20 Typical High $112.20 | Facility | None | $44.67 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $93.33 | Professional | None | $31.62 | $47.86 | $93.33 |
Well Sense Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $147.91 | Facility | None | $74.13 | $100.00 | $147.91 |
Well Sense Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | None | $58.88 | $58.88 | $70.79 |
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 $20.89 Median $20.89 Typical High $95.50 | Professional | 52 · Reduced service | $20.89 | $20.89 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $38.02 | Professional | 53 · Discontinued | $8.32 | $8.32 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $28.18 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $19.05 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $19.05 |
Where Massachusetts sits
The same service costs 2.6 times more in Kansas than in Arizona. 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
$64.57
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.