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 $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $52.48 | Professional | None | $4.47 | $4.47 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.24 Typical High $26.30 | Professional | 52 · Reduced service | $2.24 | $2.24 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.89 Typical High $7.24 | Professional | 53 · Discontinued | $0.89 | $0.89 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $7.94 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $7.94 |
AllWays Health Partners Setting Facility Modifier None Typical Low $32.36 Median $95.50 Typical High $199.53 | Facility | None | $32.36 | $95.50 | $199.53 |
AllWays Health Partners Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | None | $32.36 | $33.88 | $33.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $165.96 | Facility | None | $81.28 | $114.82 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $457.09 Typical High $7,079.46 | Facility | None | $56.23 | $457.09 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $32.36 Median $95.50 Typical High $199.53 | Facility | None | $32.36 | $95.50 | $199.53 |
Mass General Brigham Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | None | $32.36 | $33.88 | $33.88 |
United Setting Facility Modifier None Typical Low $117.49 Median $223.87 Typical High $331.13 | Facility | None | $117.49 | $223.87 | $331.13 |
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 $3.63 Median $8.13 Typical High $18.62 | Professional | 56 · Pre-op care only | $3.63 | $8.13 | $18.62 |
Where Massachusetts sits
The same service costs 35.5 times more in Texas than in Kentucky. 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· 17th of 51
$102
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.