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 $64.57 Median $64.57 Typical High $295.12 | Facility | None | $64.57 | $64.57 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $295.12 | Professional | None | $64.57 | $64.57 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $363.08 | Facility | None | $120.23 | $141.25 | $363.08 |
AllWays Health Partners Setting Professional Modifier None Typical Low $57.54 Median $151.36 Typical High $776.25 | Professional | None | $57.54 | $151.36 | $776.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $134.90 | Professional | None | $87.10 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $109.65 | Facility | None | $97.72 | $97.72 | $109.65 |
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 $57.54 Median $128.82 Typical High $131.83 | Professional | None | $57.54 | $128.82 | $131.83 |
Health New England Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $363.08 | Facility | None | $120.23 | $141.25 | $363.08 |
Mass General Brigham Setting Professional Modifier None Typical Low $57.54 Median $151.36 Typical High $776.25 | Professional | None | $57.54 | $151.36 | $776.25 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
United Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $144.54 | Professional | None | $48.98 | $79.43 | $144.54 |
Well Sense Setting Facility Modifier None Typical Low $114.82 Median $154.88 Typical High $229.09 | Facility | None | $114.82 | $154.88 | $229.09 |
Well Sense Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | None | $91.20 | $91.20 | $109.65 |
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 $9.77 Median $9.77 Typical High $44.67 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $29.51 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $29.51 |
Where Massachusetts sits
The same service costs 4.2 times more in Kansas 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· 19th of 51
$115
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.