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 $67.61 Median $67.61 Typical High $309.03 | Facility | None | $67.61 | $67.61 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $309.03 | Professional | None | $67.61 | $67.61 | $309.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $478.63 | Facility | None | $144.54 | $151.36 | $478.63 |
AllWays Health Partners Setting Professional Modifier None Typical Low $60.26 Median $154.88 Typical High $1,047.13 | Professional | None | $60.26 | $154.88 | $1,047.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $269.15 | Facility | None | $89.13 | $89.13 | $269.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | None | $109.65 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $100.00 Typical High $107.15 | Facility | None | $89.13 | $100.00 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
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 $60.26 Median $134.90 Typical High $138.04 | Professional | None | $60.26 | $134.90 | $138.04 |
Health New England Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Mass General Brigham Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $478.63 | Facility | None | $144.54 | $151.36 | $478.63 |
Mass General Brigham Setting Professional Modifier None Typical Low $60.26 Median $154.88 Typical High $1,047.13 | Professional | None | $60.26 | $154.88 | $1,047.13 |
United Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $208.93 | Facility | None | $60.26 | $75.86 | $208.93 |
United Setting Professional Modifier None Typical Low $51.29 Median $81.28 Typical High $151.36 | Professional | None | $51.29 | $81.28 | $151.36 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $181.97 Typical High $269.15 | Facility | None | $138.04 | $181.97 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | None | $100.00 | $100.00 | $120.23 |
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 $33.88 Median $33.88 Typical High $154.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $61.66 | Professional | 53 · Discontinued | $13.49 | $13.49 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $45.71 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $30.90 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $30.90 |
Where Massachusetts sits
The same service costs 2.9 times more in Montana than in Florida. 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· 17th of 51
$123
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.