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 $316.23 Median $316.23 Typical High $1,445.44 | Facility | None | $316.23 | $316.23 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $1,445.44 | Professional | None | $316.23 | $316.23 | $1,445.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $2,238.72 | Facility | None | $645.65 | $691.83 | $2,238.72 |
AllWays Health Partners Setting Professional Modifier None Typical Low $281.84 Median $741.31 Typical High $4,365.16 | Professional | None | $281.84 | $741.31 | $4,365.16 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $1,258.93 | Facility | None | $416.87 | $416.87 | $1,258.93 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $630.96 | Professional | None | $467.74 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $489.78 Typical High $501.19 | Facility | None | $416.87 | $489.78 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
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 $281.84 Median $630.96 Typical High $645.65 | Professional | None | $281.84 | $630.96 | $645.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $2,238.72 | Facility | None | $645.65 | $691.83 | $2,238.72 |
Mass General Brigham Setting Professional Modifier None Typical Low $281.84 Median $741.31 Typical High $4,365.16 | Professional | None | $281.84 | $741.31 | $4,365.16 |
United Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $891.25 | Facility | None | $165.96 | $323.59 | $891.25 |
United Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $660.69 | Professional | None | $239.88 | $380.19 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $645.65 Median $851.14 Typical High $1,258.93 | Facility | None | $645.65 | $851.14 | $1,258.93 |
Well Sense Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | None | $467.74 | $467.74 | $562.34 |
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 $158.49 Median $158.49 Typical High $724.44 | Professional | 52 · Reduced service | $158.49 | $158.49 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $288.40 | Professional | 53 · Discontinued | $63.10 | $63.10 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $213.80 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $144.54 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $144.54 |
Where Massachusetts sits
The same service costs 2.4 times more in Iowa than in Kansas. 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· 11th of 51
$575
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.