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 $1,659.59 Median $1,659.59 Typical High $7,585.78 | Facility | None | $1,659.59 | $1,659.59 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $7,585.78 | Professional | None | $1,659.59 | $1,659.59 | $7,585.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3,548.13 Median $3,630.78 Typical High $11,220.18 | Facility | None | $3,548.13 | $3,630.78 | $11,220.18 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,513.56 Median $3,890.45 Typical High $19,952.62 | Professional | None | $1,513.56 | $3,890.45 | $19,952.62 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $6,606.93 | Facility | None | $4,265.80 | $5,011.87 | $6,606.93 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,511.89 | $3,388.44 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,862.09 | $1,862.09 | $2,570.40 |
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 $1,513.56 Median $3,388.44 Typical High $3,467.37 | Professional | None | $1,513.56 | $3,388.44 | $3,467.37 |
Health New England Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $3,548.13 Median $3,630.78 Typical High $11,220.18 | Facility | None | $3,548.13 | $3,630.78 | $11,220.18 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,513.56 Median $3,890.45 Typical High $19,952.62 | Professional | None | $1,513.56 | $3,890.45 | $19,952.62 |
United Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,288.25 | $2,041.74 | $3,715.35 |
Well Sense Setting Facility Modifier None Typical Low $3,467.37 Median $4,570.88 Typical High $6,760.83 | Facility | None | $3,467.37 | $4,570.88 | $6,760.83 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
2 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 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $1,148.15 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $758.58 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $758.58 |
Where Massachusetts sits
The same service costs 2.2 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· 14th of 51
$3,236
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.