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 $54.95 Median $54.95 Typical High $81.28 | Facility | None | $54.95 | $54.95 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | None | $54.95 | $54.95 | $57.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $60.26 Typical High $177.83 | Facility | None | $52.48 | $60.26 | $177.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $245.47 | Professional | None | $54.95 | $58.88 | $245.47 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $54.95 Median $63.10 Typical High $112.20 | Facility | None | $54.95 | $63.10 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $97.72 Typical High $239.88 | Facility | None | $54.95 | $97.72 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Fallon Health Setting Facility Modifier None Typical Low $57.54 Median $79.43 Typical High $93.33 | Facility | None | $57.54 | $79.43 | $93.33 |
Fallon Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | None | $79.43 | $79.43 | $93.33 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $58.88 | Professional | None | $54.95 | $56.23 | $58.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $60.26 Typical High $177.83 | Facility | None | $52.48 | $60.26 | $177.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $245.47 | Professional | None | $54.95 | $58.88 | $245.47 |
United Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | None | $56.23 | $56.23 | $63.10 |
Well Sense Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $128.82 | Facility | None | $61.66 | $77.62 | $128.82 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | None | $54.95 | $54.95 | $74.13 |
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 $27.54 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Where Massachusetts sits
Rates are fairly even across states for this service. 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· 32nd of 51
$56.23
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.