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 $61.66 Median $61.66 Typical High $154.88 | Facility | None | $61.66 | $61.66 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
AllWays Health Partners Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $478.63 | Professional | None | $60.26 | $91.20 | $478.63 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $141.25 | Facility | None | $69.18 | $77.62 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $128.82 Typical High $269.15 | Facility | None | $79.43 | $128.82 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Fallon Health Setting Facility Modifier None Typical Low $81.28 Median $95.50 Typical High $5,888.44 | Facility | None | $81.28 | $95.50 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | None | $81.28 | $81.28 | $95.50 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $60.26 Median $102.33 Typical High $102.33 | Professional | None | $60.26 | $102.33 | $102.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $478.63 | Professional | None | $60.26 | $91.20 | $478.63 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $123.03 | Facility | None | $72.44 | $85.11 | $123.03 |
Well Sense Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
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 $30.90 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
Where Massachusetts sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 25th of 51
$61.66
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.