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 $32.36 Median $32.36 Typical High $147.91 | Facility | None | $32.36 | $32.36 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $147.91 | Professional | None | $32.36 | $32.36 | $147.91 |
AllWays Health Partners Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $239.88 | Facility | None | $69.18 | $70.79 | $239.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $28.84 Median $75.86 Typical High $389.05 | Professional | None | $28.84 | $75.86 | $389.05 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $83.18 Median $97.72 Typical High $128.82 | Facility | None | $83.18 | $97.72 | $128.82 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $61.66 | Professional | None | $43.65 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | None | $37.15 | $37.15 | $51.29 |
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 $28.84 Median $64.57 Typical High $67.61 | Professional | None | $28.84 | $64.57 | $67.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $239.88 | Facility | None | $69.18 | $70.79 | $239.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $28.84 Median $75.86 Typical High $389.05 | Professional | None | $28.84 | $75.86 | $389.05 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $24.55 Median $39.81 Typical High $72.44 | Professional | None | $24.55 | $39.81 | $72.44 |
Well Sense Setting Facility Modifier None Typical Low $48.98 Median $67.61 Typical High $97.72 | Facility | None | $48.98 | $67.61 | $97.72 |
Well Sense Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | None | $47.86 | $47.86 | $57.54 |
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 $4.90 Median $4.90 Typical High $22.39 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $14.79 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $14.79 |
Where Massachusetts sits
The same service costs 2.2 times more in Montana than in West Virginia. 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
$61.66
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.