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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $33.88 Median $125.89 Typical High $295.12 | Facility | None | $33.88 | $125.89 | $295.12 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.88 Median $125.89 Typical High $660.69 | Professional | None | $33.88 | $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 $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 $33.88 Median $33.88 Typical High $125.89 | Professional | None | $33.88 | $33.88 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $33.88 Median $125.89 Typical High $295.12 | Facility | None | $33.88 | $125.89 | $295.12 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.88 Median $125.89 Typical High $660.69 | Professional | None | $33.88 | $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 $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 $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $16.98 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.39 |
Where Massachusetts sits
The same service costs 4.2 times more in North Dakota than in Maryland. 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· 6th 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.