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 $147.91 Median $147.91 Typical High $676.08 | Facility | None | $147.91 | $147.91 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $676.08 | Professional | None | $147.91 | $147.91 | $676.08 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $323.59 Typical High $660.69 | Facility | None | $316.23 | $323.59 | $660.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $131.83 Median $346.74 Typical High $2,041.74 | Professional | None | $131.83 | $346.74 | $2,041.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $380.19 Median $446.68 Typical High $588.84 | Facility | None | $380.19 | $446.68 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $457.09 | Professional | None | $257.04 | $257.04 | $457.09 |
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 $131.83 Median $295.12 Typical High $309.03 | Professional | None | $131.83 | $295.12 | $309.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $323.59 Typical High $660.69 | Facility | None | $316.23 | $323.59 | $660.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $131.83 Median $346.74 Typical High $2,041.74 | Professional | None | $131.83 | $346.74 | $2,041.74 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $331.13 | Professional | None | $112.20 | $181.97 | $331.13 |
Well Sense Setting Facility Modifier None Typical Low $223.87 Median $309.03 Typical High $446.68 | Facility | None | $223.87 | $309.03 | $446.68 |
Well Sense Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | None | $199.53 | $199.53 | $239.88 |
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 $74.13 Median $74.13 Typical High $338.84 | Professional | 52 · Reduced service | $74.13 | $74.13 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $134.90 | Professional | 53 · Discontinued | $29.51 | $29.51 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $102.33 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $67.61 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $67.61 |
Where Massachusetts sits
The same service costs 3.0 times more in Iowa 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· 16th of 51
$295
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.