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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
AllWays Health Partners Setting Facility Modifier None Typical Low $204.17 Median $316.23 Typical High $331.13 | Facility | None | $204.17 | $316.23 | $331.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $660.69 | Professional | None | $125.89 | $125.89 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $269.15 Typical High $549.54 | Facility | None | $162.18 | $269.15 | $549.54 |
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 $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $204.17 Median $316.23 Typical High $331.13 | Facility | None | $204.17 | $316.23 | $331.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $660.69 | Professional | None | $125.89 | $125.89 | $660.69 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | None | $125.89 | $125.89 | $181.97 |
Well Sense Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $309.03 | Facility | None | $147.91 | $186.21 | $309.03 |
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 $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where Massachusetts sits
The same service costs 2.1 times more in Alaska than in Montana. 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· 29th 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.