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 $229.09 Median $229.09 Typical High $1,047.13 | Facility | None | $229.09 | $229.09 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $1,047.13 | Professional | None | $229.09 | $229.09 | $1,047.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $501.19 Typical High $1,148.15 | Facility | None | $446.68 | $501.19 | $1,148.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $204.17 Median $537.03 Typical High $2,691.53 | Professional | None | $204.17 | $537.03 | $2,691.53 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $588.84 Median $691.83 Typical High $912.01 | Facility | None | $588.84 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $416.87 Typical High $416.87 | Facility | None | $302.00 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $602.56 | Professional | None | $354.81 | $354.81 | $602.56 |
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 $204.17 Median $457.09 Typical High $478.63 | Professional | None | $204.17 | $457.09 | $478.63 |
Health New England Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $501.19 Typical High $1,148.15 | Facility | None | $446.68 | $501.19 | $1,148.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $204.17 Median $537.03 Typical High $2,691.53 | Professional | None | $204.17 | $537.03 | $2,691.53 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $512.86 | Professional | None | $173.78 | $281.84 | $512.86 |
Well Sense Setting Facility Modifier None Typical Low $354.81 Median $489.78 Typical High $707.95 | Facility | None | $354.81 | $489.78 | $707.95 |
Well Sense Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | None | $309.03 | $309.03 | $371.54 |
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 $114.82 Median $114.82 Typical High $524.81 | Professional | 52 · Reduced service | $114.82 | $114.82 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $208.93 | Professional | 53 · Discontinued | $45.71 | $45.71 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $158.49 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $104.71 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $104.71 |
Where Massachusetts sits
The same service costs 2.5 times more in Montana than in New York. 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· 11th of 51
$437
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.