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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
AllWays Health Partners Setting Facility Modifier None Typical Low $54.95 Median $138.04 Typical High $181.97 | Facility | None | $54.95 | $138.04 | $181.97 |
AllWays Health Partners Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $154.88 | Professional | None | $56.23 | $75.86 | $154.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $87.10 Median $97.72 Typical High $177.83 | Facility | None | $87.10 | $97.72 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $331.13 | Facility | None | $100.00 | $162.18 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $77.62 | Professional | None | $69.18 | $77.62 | $77.62 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $128.82 | Professional | None | $56.23 | $75.86 | $128.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $54.95 Median $138.04 Typical High $181.97 | Facility | None | $54.95 | $138.04 | $181.97 |
Mass General Brigham Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $154.88 | Professional | None | $56.23 | $75.86 | $154.88 |
United Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $154.88 | Professional | None | $75.86 | $75.86 | $154.88 |
Well Sense Setting Facility Modifier None Typical Low $77.62 Median $107.15 Typical High $158.49 | Facility | None | $77.62 | $107.15 | $158.49 |
Well Sense Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | None | $77.62 | $77.62 | $93.33 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Where Massachusetts sits
The same service costs 25.1 times more in Alabama than in Nebraska. 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· 10th of 51
$77.62
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.