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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $467.74 | Facility | None | $125.89 | $151.36 | $467.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $660.69 | Professional | None | $125.89 | $151.36 | $660.69 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $16.60 Median $19.50 Typical High $25.70 | Facility | None | $16.60 | $19.50 | $25.70 |
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 $45.71 Median $45.71 Typical High $125.89 | Professional | None | $45.71 | $45.71 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $467.74 | Facility | None | $125.89 | $151.36 | $467.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $660.69 | Professional | None | $125.89 | $151.36 | $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 $22.39 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 54 · Surgery only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.57 |
Where Massachusetts sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 7th 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.