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 $29.51 Median $29.51 Typical High $134.90 | Facility | None | $29.51 | $29.51 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $134.90 | Professional | None | $29.51 | $29.51 | $134.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $54.95 Median $64.57 Typical High $208.93 | Facility | None | $54.95 | $64.57 | $208.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $26.30 Median $69.18 Typical High $371.54 | Professional | None | $26.30 | $69.18 | $371.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $117.49 | Facility | None | $38.90 | $38.90 | $117.49 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $60.26 | Professional | None | $47.86 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $38.90 | Facility | None | $34.67 | $34.67 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
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 $26.30 Median $58.88 Typical High $61.66 | Professional | None | $26.30 | $58.88 | $61.66 |
Health New England Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Mass General Brigham Setting Facility Modifier None Typical Low $54.95 Median $64.57 Typical High $208.93 | Facility | None | $54.95 | $64.57 | $208.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $26.30 Median $69.18 Typical High $371.54 | Professional | None | $26.30 | $69.18 | $371.54 |
United Setting Facility Modifier None Typical Low $27.54 Median $29.51 Typical High $75.86 | Facility | None | $27.54 | $29.51 | $75.86 |
United Setting Professional Modifier None Typical Low $22.39 Median $35.48 Typical High $64.57 | Professional | None | $22.39 | $35.48 | $64.57 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $120.23 | Facility | None | $60.26 | $81.28 | $120.23 |
Well Sense Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | None | $43.65 | $43.65 | $52.48 |
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 $14.79 Median $14.79 Typical High $67.61 | Professional | 52 · Reduced service | $14.79 | $14.79 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $26.92 | Professional | 53 · Discontinued | $5.89 | $5.89 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $19.95 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $13.49 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $13.49 |
Where Massachusetts sits
The same service costs 2.5 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
$50.12
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.