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 $112.20 Median $112.20 Typical High $1,621.81 | Facility | None | $112.20 | $112.20 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $512.86 | Professional | None | $112.20 | $112.20 | $512.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $223.87 Median $245.47 Typical High $562.34 | Facility | None | $223.87 | $245.47 | $562.34 |
AllWays Health Partners Setting Professional Modifier None Typical Low $100.00 Median $263.03 Typical High $1,348.96 | Professional | None | $100.00 | $263.03 | $1,348.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $263.03 Median $331.13 Typical High $446.68 | Facility | None | $263.03 | $331.13 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
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 $100.00 Median $223.87 Typical High $234.42 | Professional | None | $100.00 | $223.87 | $234.42 |
Health New England Setting Facility Modifier None Typical Low $281.84 Median $2,041.74 Typical High $6,456.54 | Facility | None | $281.84 | $2,041.74 | $6,456.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $223.87 Median $245.47 Typical High $562.34 | Facility | None | $223.87 | $245.47 | $562.34 |
Mass General Brigham Setting Professional Modifier None Typical Low $100.00 Median $263.03 Typical High $1,348.96 | Professional | None | $100.00 | $263.03 | $1,348.96 |
United Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $251.19 | Professional | None | $85.11 | $138.04 | $251.19 |
Well Sense Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $346.74 | Facility | None | $173.78 | $239.88 | $346.74 |
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 $16.98 Median $16.98 Typical High $77.62 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $51.29 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $51.29 |
Where Massachusetts sits
The same service costs 2.6 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· 13th of 51
$219
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.