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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $309.03 Median $1,148.15 Typical High $1,479.11 | Facility | None | $309.03 | $1,148.15 | $1,479.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $616.60 | Professional | None | $489.78 | $588.84 | $616.60 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $275.42 Median $316.23 Typical High $575.44 | Facility | None | $275.42 | $316.23 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $912.01 Typical High $2,187.76 | Facility | None | $302.00 | $912.01 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $416.87 Typical High $6,918.31 | Facility | None | $83.18 | $416.87 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $616.60 | Professional | None | $512.86 | $537.03 | $616.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $309.03 Median $1,148.15 Typical High $1,479.11 | Facility | None | $309.03 | $1,148.15 | $1,479.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $616.60 | Professional | None | $489.78 | $588.84 | $616.60 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
United Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | None | $575.44 | $575.44 | $616.60 |
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 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Where Massachusetts sits
The same service costs 1.6 times more in Alaska than in Idaho. 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· 8th of 51
$575
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.