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 $245.47 Median $245.47 Typical High $1,122.02 | Facility | None | $245.47 | $245.47 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $1,122.02 | Professional | None | $245.47 | $245.47 | $1,122.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $398.11 Median $436.52 Typical High $1,071.52 | Facility | None | $398.11 | $436.52 | $1,071.52 |
AllWays Health Partners Setting Professional Modifier None Typical Low $218.78 Median $575.44 Typical High $2,818.38 | Professional | None | $218.78 | $575.44 | $2,818.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $630.96 Median $724.44 Typical High $977.24 | Facility | None | $630.96 | $724.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $389.05 | Facility | None | $371.54 | $371.54 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $478.63 | Professional | None | $316.23 | $316.23 | $478.63 |
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 $213.80 Median $489.78 Typical High $501.19 | Professional | None | $213.80 | $489.78 | $501.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $398.11 Median $436.52 Typical High $1,071.52 | Facility | None | $398.11 | $436.52 | $1,071.52 |
Mass General Brigham Setting Professional Modifier None Typical Low $218.78 Median $575.44 Typical High $2,818.38 | Professional | None | $218.78 | $575.44 | $2,818.38 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $512.86 | Professional | None | $186.21 | $281.84 | $512.86 |
Well Sense Setting Facility Modifier None Typical Low $371.54 Median $512.86 Typical High $724.44 | Facility | None | $371.54 | $512.86 | $724.44 |
Well Sense Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | None | $331.13 | $331.13 | $398.11 |
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 $123.03 Median $123.03 Typical High $562.34 | Professional | 52 · Reduced service | $123.03 | $123.03 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $223.87 | Professional | 53 · Discontinued | $48.98 | $48.98 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $165.96 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $112.20 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $112.20 |
Where Massachusetts sits
The same service costs 3.4 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· 7th of 51
$457
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.