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 $1,148.15 Median $1,148.15 Typical High $5,248.07 | Facility | None | $1,148.15 | $1,148.15 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $5,248.07 | Professional | None | $1,148.15 | $1,148.15 | $5,248.07 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $4,570.88 | Facility | None | $2,238.72 | $2,511.89 | $4,570.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,023.29 Median $2,691.53 Typical High $13,489.63 | Professional | None | $1,023.29 | $2,691.53 | $13,489.63 |
BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $3,388.44 Typical High $4,570.88 | Facility | None | $2,951.21 | $3,388.44 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
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 $1,023.29 Median $2,290.87 Typical High $2,398.83 | Professional | None | $1,023.29 | $2,290.87 | $2,398.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $4,570.88 | Facility | None | $2,238.72 | $2,511.89 | $4,570.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,023.29 Median $2,691.53 Typical High $13,489.63 | Professional | None | $1,023.29 | $2,691.53 | $13,489.63 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,570.40 | Professional | None | $870.96 | $1,380.38 | $2,570.40 |
Well Sense Setting Facility Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,398.83 | $3,467.37 |
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 $575.44 Median $575.44 Typical High $2,630.27 | Professional | 52 · Reduced service | $575.44 | $575.44 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $1,047.13 | Professional | 53 · Discontinued | $229.09 | $229.09 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $794.33 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $524.81 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $524.81 |
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· 11th of 51
$2,188
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.