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 $38.02 Median $38.02 Typical High $173.78 | Facility | None | $38.02 | $38.02 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $173.78 | Professional | None | $38.02 | $38.02 | $173.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $79.43 Median $81.28 Typical High $269.15 | Facility | None | $79.43 | $81.28 | $269.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.88 Median $87.10 Typical High $501.19 | Professional | None | $33.88 | $87.10 | $501.19 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $151.36 | Facility | None | $50.12 | $50.12 | $151.36 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $75.86 | Professional | None | $56.23 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $56.23 | Facility | None | $50.12 | $50.12 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | None | $37.15 | $37.15 | $51.29 |
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 $33.88 Median $75.86 Typical High $77.62 | Professional | None | $33.88 | $75.86 | $77.62 |
Health New England Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Mass General Brigham Setting Facility Modifier None Typical Low $79.43 Median $81.28 Typical High $269.15 | Facility | None | $79.43 | $81.28 | $269.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.88 Median $87.10 Typical High $501.19 | Professional | None | $33.88 | $87.10 | $501.19 |
United Setting Facility Modifier None Typical Low $32.36 Median $38.90 Typical High $104.71 | Facility | None | $32.36 | $38.90 | $104.71 |
United Setting Professional Modifier None Typical Low $28.84 Median $45.71 Typical High $85.11 | Professional | None | $28.84 | $45.71 | $85.11 |
Well Sense Setting Facility Modifier None Typical Low $67.61 Median $89.13 Typical High $131.83 | Facility | None | $67.61 | $89.13 | $131.83 |
Well Sense Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | None | $53.70 | $53.70 | $63.10 |
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 $18.62 Median $18.62 Typical High $85.11 | Professional | 52 · Reduced service | $18.62 | $18.62 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $34.67 | Professional | 53 · Discontinued | $7.59 | $7.59 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $25.70 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $17.38 |
Where Massachusetts sits
The same service costs 2.1 times more in Arkansas than in Colorado. 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
$63.10
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.