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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | None | $138.04 | $138.04 | $141.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $125.89 Median $138.04 Typical High $416.87 | Facility | None | $125.89 | $138.04 | $416.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $1,445.44 | Professional | None | $125.89 | $138.04 | $1,445.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $549.54 | Facility | None | $269.15 | $309.03 | $549.54 |
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 $83.18 Median $199.53 Typical High $6,918.31 | Facility | None | $83.18 | $199.53 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $141.25 | Professional | None | $125.89 | $138.04 | $141.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $125.89 Median $138.04 Typical High $416.87 | Facility | None | $125.89 | $138.04 | $416.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $1,445.44 | Professional | None | $125.89 | $138.04 | $1,445.44 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $194.98 | Professional | None | $125.89 | $125.89 | $194.98 |
Well Sense Setting Facility Modifier None Typical Low $102.33 Median $141.25 Typical High $208.93 | Facility | None | $102.33 | $141.25 | $208.93 |
Well Sense Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | None | $102.33 | $102.33 | $123.03 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where Massachusetts sits
The same service costs 2.2 times more in Alaska 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· 24th of 51
$138
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.