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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $323.59 | Facility | None | $97.72 | $125.89 | $323.59 |
AllWays Health Partners Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $660.69 | Professional | None | $97.72 | $125.89 | $660.69 |
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 $97.72 Median $97.72 Typical High $125.89 | Professional | None | $97.72 | $97.72 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $323.59 | Facility | None | $97.72 | $125.89 | $323.59 |
Mass General Brigham Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $660.69 | Professional | None | $97.72 | $125.89 | $660.69 |
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 $213.80 Median $213.80 Typical High $257.04 | Professional | None | $213.80 | $213.80 | $257.04 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $9.77 |
Where Massachusetts sits
The same service costs 2.5 times more in Wyoming than in New Jersey. 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· 21st 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.