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 $295.12 Median $295.12 Typical High $1,348.96 | Facility | None | $295.12 | $295.12 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $1,348.96 | Professional | None | $295.12 | $295.12 | $1,348.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $562.34 Median $630.96 Typical High $1,288.25 | Facility | None | $562.34 | $630.96 | $1,288.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $676.08 Typical High $3,388.44 | Professional | None | $263.03 | $676.08 | $3,388.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $741.31 Median $870.96 Typical High $1,148.15 | Facility | None | $741.31 | $870.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | None | $316.23 | $316.23 | $446.68 |
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 $263.03 Median $588.84 Typical High $602.56 | Professional | None | $263.03 | $588.84 | $602.56 |
Mass General Brigham Setting Facility Modifier None Typical Low $562.34 Median $630.96 Typical High $1,288.25 | Facility | None | $562.34 | $630.96 | $1,288.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $676.08 Typical High $3,388.44 | Professional | None | $263.03 | $676.08 | $3,388.44 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $645.65 | Professional | None | $223.87 | $354.81 | $645.65 |
Well Sense Setting Facility Modifier None Typical Low $436.52 Median $602.56 Typical High $870.96 | Facility | None | $436.52 | $602.56 | $870.96 |
Well Sense Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | None | $389.05 | $389.05 | $467.74 |
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 $144.54 Median $144.54 Typical High $660.69 | Professional | 52 · Reduced service | $144.54 | $144.54 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $269.15 | Professional | 53 · Discontinued | $58.88 | $58.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $199.53 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $134.90 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $134.90 |
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· 12th of 51
$550
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.