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 $128.82 Median $295.12 Typical High $354.81 | Facility | None | $128.82 | $295.12 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $120.23 Median $199.53 Typical High $371.54 | Facility | None | $120.23 | $199.53 | $371.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $97.72 Median $316.23 Typical High $812.83 | Professional | None | $97.72 | $316.23 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $158.49 Typical High $5,888.44 | Facility | None | $83.18 | $158.49 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | None | $134.90 | $134.90 | $158.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $295.12 | Professional | None | $109.65 | $114.82 | $295.12 |
Mass General Brigham Setting Facility Modifier None Typical Low $120.23 Median $199.53 Typical High $371.54 | Facility | None | $120.23 | $199.53 | $371.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $97.72 Median $316.23 Typical High $812.83 | Professional | None | $97.72 | $316.23 | $812.83 |
United Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $407.38 | Professional | None | $85.11 | $147.91 | $407.38 |
Well Sense Setting Facility Modifier None Typical Low $223.87 Median $309.03 Typical High $457.09 | Facility | None | $223.87 | $309.03 | $457.09 |
Well Sense Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $302.00 | Professional | None | $223.87 | $223.87 | $302.00 |
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 $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Where Massachusetts sits
The same service costs 3.3 times more in Alaska than in Wyoming. 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· 7th of 51
$148
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.