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 $37.15 Median $37.15 Typical High $169.82 | Facility | None | $37.15 | $37.15 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $169.82 | Professional | None | $37.15 | $37.15 | $169.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $275.42 | Facility | None | $81.28 | $81.28 | $275.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.11 Median $87.10 Typical High $446.68 | Professional | None | $33.11 | $87.10 | $446.68 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $112.20 Median $128.82 Typical High $169.82 | Facility | None | $112.20 | $128.82 | $169.82 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $97.72 | Professional | None | $58.88 | $58.88 | $97.72 |
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 $33.11 Median $74.13 Typical High $77.62 | Professional | None | $33.11 | $74.13 | $77.62 |
Mass General Brigham Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $275.42 | Facility | None | $81.28 | $81.28 | $275.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.11 Median $87.10 Typical High $446.68 | Professional | None | $33.11 | $87.10 | $446.68 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $28.18 Median $45.71 Typical High $83.18 | Professional | None | $28.18 | $45.71 | $83.18 |
Well Sense Setting Facility Modifier None Typical Low $56.23 Median $77.62 Typical High $112.20 | Facility | None | $56.23 | $77.62 | $112.20 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | None | $54.95 | $54.95 | $66.07 |
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 $7.41 Median $7.41 Typical High $33.88 | Professional | 53 · Discontinued | $7.41 | $7.41 | $33.88 |
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 $3.72 Median $3.72 Typical High $16.98 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $16.98 |
Where Massachusetts sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 15th of 51
$70.79
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.