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 $39.81 Median $39.81 Typical High $181.97 | Facility | None | $39.81 | $39.81 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $181.97 | Professional | None | $39.81 | $39.81 | $181.97 |
AllWays Health Partners Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $229.09 | Facility | None | $75.86 | $87.10 | $229.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $36.31 Median $93.33 Typical High $758.58 | Professional | None | $36.31 | $93.33 | $758.58 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $162.18 | Facility | None | $53.70 | $53.70 | $162.18 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | None | $60.26 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Facility | None | $51.29 | $51.29 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $52.48 | Professional | None | $38.02 | $38.02 | $52.48 |
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 $36.31 Median $81.28 Typical High $81.28 | Professional | None | $36.31 | $81.28 | $81.28 |
Health New England Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $229.09 | Facility | None | $75.86 | $87.10 | $229.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $36.31 Median $93.33 Typical High $758.58 | Professional | None | $36.31 | $93.33 | $758.58 |
United Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $109.65 | Facility | None | $53.70 | $64.57 | $109.65 |
United Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $83.18 | Professional | None | $30.90 | $45.71 | $83.18 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $95.50 Typical High $141.25 | Facility | None | $72.44 | $95.50 | $141.25 |
Well Sense Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | None | $56.23 | $56.23 | $67.61 |
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 $19.95 Median $19.95 Typical High $91.20 | Professional | 52 · Reduced service | $19.95 | $19.95 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $37.15 | Professional | 53 · Discontinued | $7.94 | $7.94 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $27.54 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $18.20 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $18.20 |
Where Massachusetts sits
The same service costs 4.9 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· 16th of 51
$67.61
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.