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 $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,754.40 | Professional | None | $4,265.80 | $4,265.80 | $5,754.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $8,709.64 Median $9,332.54 Typical High $29,512.09 | Facility | None | $8,709.64 | $9,332.54 | $29,512.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,801.89 Median $10,000.00 Typical High $52,480.75 | Professional | None | $3,801.89 | $10,000.00 | $52,480.75 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $977.24 Median $12,589.25 Typical High $16,982.44 | Facility | None | $977.24 | $12,589.25 | $16,982.44 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,760.83 | Professional | None | $4,786.30 | $4,786.30 | $6,760.83 |
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 $3,801.89 Median $8,511.38 Typical High $8,912.51 | Professional | None | $3,801.89 | $8,511.38 | $8,912.51 |
Mass General Brigham Setting Facility Modifier None Typical Low $8,709.64 Median $9,332.54 Typical High $29,512.09 | Facility | None | $8,709.64 | $9,332.54 | $29,512.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,801.89 Median $10,000.00 Typical High $52,480.75 | Professional | None | $3,801.89 | $10,000.00 | $52,480.75 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $9,549.93 | Professional | None | $3,235.94 | $5,370.32 | $9,549.93 |
Well Sense Setting Facility Modifier None Typical Low $6,309.57 Median $8,709.64 Typical High $12,302.69 | Facility | None | $6,309.57 | $8,709.64 | $12,302.69 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $2,137.96 Median $2,137.96 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $1,148.15 | Professional | 53 · Discontinued | $851.14 | $851.14 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | 55 · Aftercare only | $645.65 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $575.44 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $575.44 |
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· 14th of 51
$7,943
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.