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 $363.08 Median $363.08 Typical High $1,659.59 | Facility | None | $363.08 | $363.08 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $1,659.59 | Professional | None | $363.08 | $363.08 | $1,659.59 |
AllWays Health Partners Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $2,570.40 | Facility | None | $630.96 | $794.33 | $2,570.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $323.59 Median $851.14 Typical High $3,801.89 | Professional | None | $323.59 | $851.14 | $3,801.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $1,445.44 | Facility | None | $478.63 | $478.63 | $1,445.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | None | $602.56 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $478.63 | Facility | None | $389.05 | $389.05 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $398.11 | Professional | None | $281.84 | $281.84 | $398.11 |
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 $316.23 Median $724.44 Typical High $741.31 | Professional | None | $316.23 | $724.44 | $741.31 |
Health New England Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $2,570.40 | Facility | None | $630.96 | $794.33 | $2,570.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $323.59 Median $851.14 Typical High $3,801.89 | Professional | None | $323.59 | $851.14 | $3,801.89 |
United Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $851.14 | Facility | None | $281.84 | $331.13 | $851.14 |
United Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $758.58 | Professional | None | $275.42 | $416.87 | $758.58 |
Well Sense Setting Facility Modifier None Typical Low $741.31 Median $977.24 Typical High $1,479.11 | Facility | None | $741.31 | $977.24 | $1,479.11 |
Well Sense Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $645.65 | Professional | None | $537.03 | $537.03 | $645.65 |
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 $181.97 Median $181.97 Typical High $831.76 | Professional | 52 · Reduced service | $181.97 | $181.97 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $331.13 | Professional | 53 · Discontinued | $72.44 | $72.44 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $251.19 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $165.96 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $165.96 |
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· 4th of 51
$631
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.