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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
AllWays Health Partners Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $467.74 | Facility | None | $125.89 | $181.97 | $467.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $660.69 | Professional | None | $125.89 | $181.97 | $660.69 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $575.44 Median $676.08 Typical High $891.25 | Facility | None | $575.44 | $676.08 | $891.25 |
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 $181.97 Typical High $181.97 | Professional | None | $125.89 | $181.97 | $181.97 |
Mass General Brigham Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $467.74 | Facility | None | $125.89 | $181.97 | $467.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $660.69 | Professional | None | $125.89 | $181.97 | $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 $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
5 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 $91.20 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Where Massachusetts sits
The same service costs 3.6 times more in Wyoming 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· 21st of 51
$182
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.