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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | None | $67.61 | $67.61 | $77.62 |
AllWays Health Partners Setting Facility Modifier None Typical Low $141.25 Median $165.96 Typical High $218.78 | Facility | None | $141.25 | $165.96 | $218.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $269.15 | Professional | None | $67.61 | $85.11 | $269.15 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $138.04 | Facility | None | $67.61 | $75.86 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $288.40 | Facility | None | $87.10 | $120.23 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $169.82 | Professional | None | $67.61 | $67.61 | $169.82 |
Fallon Health Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $165.96 | Facility | None | $81.28 | $102.33 | $165.96 |
Fallon Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | None | $141.25 | $141.25 | $165.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $269.15 | Professional | None | $67.61 | $81.28 | $269.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $141.25 Median $165.96 Typical High $218.78 | Facility | None | $141.25 | $165.96 | $218.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $269.15 | Professional | None | $67.61 | $85.11 | $269.15 |
Tufts Setting Facility Modifier None Typical Low $138.04 Median $323.59 Typical High $489.78 | Facility | None | $138.04 | $323.59 | $489.78 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $269.15 | Professional | None | $79.43 | $85.11 | $269.15 |
Well Sense Setting Facility Modifier None Typical Low $83.18 Median $102.33 Typical High $158.49 | Facility | None | $83.18 | $102.33 | $158.49 |
Well Sense Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | None | $67.61 | $67.61 | $81.28 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where Massachusetts sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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· 19th of 51
$87.10
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.