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 $53.70 Median $53.70 Typical High $109.65 | Facility | None | $53.70 | $53.70 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
AllWays Health Partners Setting Facility Modifier None Typical Low $37.15 Median $295.12 Typical High $426.58 | Facility | None | $37.15 | $295.12 | $426.58 |
AllWays Health Partners Setting Professional Modifier None Typical Low $27.54 Median $52.48 Typical High $89.13 | Professional | None | $27.54 | $52.48 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $112.20 Typical High $234.42 | Facility | None | $69.18 | $112.20 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $67.61 | Professional | None | $53.70 | $53.70 | $67.61 |
Fallon Health Setting Facility Modifier None Typical Low $40.74 Median $47.86 Typical High $5,888.44 | Facility | None | $40.74 | $47.86 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | None | $40.74 | $40.74 | $47.86 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $89.13 | Professional | None | $52.48 | $53.70 | $89.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $37.15 Median $295.12 Typical High $426.58 | Facility | None | $37.15 | $295.12 | $426.58 |
Mass General Brigham Setting Professional Modifier None Typical Low $27.54 Median $52.48 Typical High $89.13 | Professional | None | $27.54 | $52.48 | $89.13 |
United Setting Facility Modifier None Typical Low $47.86 Median $91.20 Typical High $134.90 | Facility | None | $47.86 | $91.20 | $134.90 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $89.13 | Professional | None | $52.48 | $52.48 | $89.13 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $81.28 Typical High $3,630.78 | Facility | None | $63.10 | $81.28 | $3,630.78 |
Well Sense Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | None | $38.02 | $38.02 | $45.71 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where Massachusetts sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 27th of 51
$53.70
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.