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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $660.69 | Professional | None | $69.18 | $125.89 | $660.69 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $57.54 Median $64.57 Typical High $117.49 | Facility | None | $57.54 | $64.57 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $229.09 Typical High $389.05 | Facility | None | $162.18 | $229.09 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Fallon Health Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $363.08 | Facility | None | $147.91 | $181.97 | $363.08 |
Fallon Health Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $234.42 | Professional | None | $169.82 | $199.53 | $234.42 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $125.89 | Professional | None | $69.18 | $69.18 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $660.69 | Professional | None | $69.18 | $125.89 | $660.69 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | None | $125.89 | $125.89 | $141.25 |
Well Sense Setting Facility Modifier None Typical Low $51.29 Median $70.79 Typical High $104.71 | Facility | None | $51.29 | $70.79 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | None | $51.29 | $51.29 | $61.66 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Where Massachusetts sits
The same service costs 2.7 times more in North Dakota than in North Carolina. 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· 15th of 51
$126
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.