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 $22.91 Median $22.91 Typical High $616.60 | Facility | None | $22.91 | $22.91 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $295.12 | Professional | None | $22.91 | $22.91 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $11.48 Typical High $147.91 | Professional | 52 · Reduced service | $11.48 | $11.48 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $58.88 | Professional | 53 · Discontinued | $4.57 | $4.57 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $44.67 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $44.67 |
AllWays Health Partners Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $933.25 | Facility | None | $190.55 | $295.12 | $933.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | None | $295.12 | $316.23 | $316.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $426.58 | Facility | None | $208.93 | $295.12 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $1,122.02 Typical High $7,079.46 | Facility | None | $83.18 | $1,122.02 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Health New England Setting Facility Modifier None Typical Low $269.15 Median $489.78 Typical High $691.83 | Facility | None | $269.15 | $489.78 | $691.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $933.25 | Facility | None | $190.55 | $295.12 | $933.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | None | $295.12 | $316.23 | $316.23 |
United Setting Facility Modifier None Typical Low $251.19 Median $478.63 Typical High $707.95 | Facility | None | $251.19 | $478.63 | $707.95 |
United Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
1 more rate 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 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $31.62 |
Where Massachusetts sits
The same service costs 5.2 times more in Alaska than in Georgia. 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· 43rd of 51
$129
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.