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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $173.78 | Professional | None | $38.90 | $38.90 | $173.78 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $37.15 Median $42.66 Typical High $75.86 | Facility | None | $37.15 | $42.66 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $69.18 Typical High $144.54 | Facility | None | $42.66 | $69.18 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $38.90 | Professional | None | $10.00 | $10.00 | $38.90 |
Mass General Brigham Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $173.78 | Professional | None | $38.90 | $38.90 | $173.78 |
United Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $42.66 | Professional | None | $38.90 | $38.90 | $42.66 |
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 $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
Where Massachusetts sits
The same service costs 5.6 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· 3rd of 51
$38.90
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.