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 $1,096.48 Median $1,096.48 Typical High $5,011.87 | Facility | None | $1,096.48 | $1,096.48 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $5,011.87 | Professional | None | $1,096.48 | $1,096.48 | $5,011.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2,238.72 Median $2,344.23 Typical High $7,079.46 | Facility | None | $2,238.72 | $2,344.23 | $7,079.46 |
AllWays Health Partners Setting Professional Modifier None Typical Low $977.24 Median $2,511.89 Typical High $13,182.57 | Professional | None | $977.24 | $2,511.89 | $13,182.57 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $2,511.89 Median $3,235.94 Typical High $4,365.16 | Facility | None | $2,511.89 | $3,235.94 | $4,365.16 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,621.81 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,445.44 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
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 $977.24 Median $2,187.76 Typical High $2,238.72 | Professional | None | $977.24 | $2,187.76 | $2,238.72 |
Health New England Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Mass General Brigham Setting Facility Modifier None Typical Low $2,238.72 Median $2,344.23 Typical High $7,079.46 | Facility | None | $2,238.72 | $2,344.23 | $7,079.46 |
Mass General Brigham Setting Professional Modifier None Typical Low $977.24 Median $2,511.89 Typical High $13,182.57 | Professional | None | $977.24 | $2,511.89 | $13,182.57 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,148.15 Typical High $3,090.30 | Facility | None | $977.24 | $1,148.15 | $3,090.30 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $2,290.87 | Professional | None | $831.76 | $1,318.26 | $2,290.87 |
Well Sense Setting Facility Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $4,365.16 | Facility | None | $2,238.72 | $2,951.21 | $4,365.16 |
Well Sense Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,621.81 | $1,949.84 |
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 $549.54 Median $549.54 Typical High $2,511.89 | Professional | 52 · Reduced service | $549.54 | $549.54 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $1,000.00 | Professional | 53 · Discontinued | $218.78 | $218.78 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $741.31 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $501.19 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $501.19 |
Where Massachusetts sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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
$2,042
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.