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 $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $57.54 | Professional | None | $3.47 | $3.47 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.74 Median $1.74 Typical High $28.84 | Professional | 52 · Reduced service | $1.74 | $1.74 | $28.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $134.90 Median $257.04 Typical High $812.83 | Facility | None | $134.90 | $257.04 | $812.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | None | $257.04 | $269.15 | $269.15 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $158.49 Median $223.87 Typical High $323.59 | Facility | None | $158.49 | $223.87 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $870.96 Typical High $7,079.46 | Facility | None | $83.18 | $870.96 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $134.90 Median $257.04 Typical High $812.83 | Facility | None | $134.90 | $257.04 | $812.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | None | $257.04 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $204.17 Median $389.05 Typical High $575.44 | Facility | None | $204.17 | $389.05 | $575.44 |
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 |
3 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 53 · Discontinued Typical Low $11.48 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $11.48 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $8.71 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.75 | $8.13 | $9.12 |
Where Massachusetts sits
The same service costs 13.8 times more in Indiana than in Pennsylvania. 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· 21st of 51
$93.33
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.