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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $295.12 | Facility | None | $89.13 | $134.90 | $295.12 |
AllWays Health Partners Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $1,905.46 | Professional | None | $89.13 | $125.89 | $1,905.46 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $3,235.94 | Facility | None | $1,584.89 | $1,819.70 | $3,235.94 |
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 $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 $89.13 Median $89.13 Typical High $125.89 | Professional | None | $89.13 | $89.13 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $295.12 | Facility | None | $89.13 | $134.90 | $295.12 |
Mass General Brigham Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $1,905.46 | Professional | None | $89.13 | $125.89 | $1,905.46 |
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 |
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 $44.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $8.91 |
Where Massachusetts sits
The same service costs 17.4 times more in Wyoming 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· 23rd 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.