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 $53.70 Median $53.70 Typical High $245.47 | Facility | None | $53.70 | $53.70 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $245.47 | Professional | None | $53.70 | $53.70 | $245.47 |
AllWays Health Partners Setting Facility Modifier None Typical Low $107.15 Median $117.49 Typical High $398.11 | Facility | None | $107.15 | $117.49 | $398.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $47.86 Median $125.89 Typical High $645.65 | Professional | None | $47.86 | $125.89 | $645.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $138.04 Median $162.18 Typical High $213.80 | Facility | None | $138.04 | $162.18 | $213.80 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | None | $81.28 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $141.25 | Professional | None | $85.11 | $85.11 | $141.25 |
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 $47.86 Median $107.15 Typical High $112.20 | Professional | None | $47.86 | $107.15 | $112.20 |
Mass General Brigham Setting Facility Modifier None Typical Low $107.15 Median $117.49 Typical High $398.11 | Facility | None | $107.15 | $117.49 | $398.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $47.86 Median $125.89 Typical High $645.65 | Professional | None | $47.86 | $125.89 | $645.65 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
United Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $120.23 | Professional | None | $40.74 | $66.07 | $120.23 |
Well Sense Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $181.97 | Facility | None | $79.43 | $109.65 | $181.97 |
Well Sense Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | None | $72.44 | $72.44 | $87.10 |
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 $26.92 Median $26.92 Typical High $123.03 | Professional | 52 · Reduced service | $26.92 | $26.92 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $48.98 | Professional | 53 · Discontinued | $10.72 | $10.72 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $37.15 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $24.55 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $24.55 |
Where Massachusetts sits
The same service costs 2.4 times more in Indiana than in Kentucky. 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· 17th of 51
$102
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.