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 $31.62 Median $31.62 Typical High $51.29 | Facility | None | $31.62 | $31.62 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | None | $31.62 | $31.62 | $33.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $79.43 Typical High $104.71 | Facility | None | $45.71 | $79.43 | $104.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $165.96 | Professional | None | $31.62 | $38.02 | $165.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $31.62 Median $36.31 Typical High $66.07 | Facility | None | $31.62 | $36.31 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $138.04 | Facility | None | $38.02 | $57.54 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Fallon Health Setting Facility Modifier None Typical Low $35.48 Median $53.70 Typical High $63.10 | Facility | None | $35.48 | $53.70 | $63.10 |
Fallon Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | None | $53.70 | $53.70 | $63.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $38.02 | Professional | None | $31.62 | $34.67 | $38.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $45.71 Median $79.43 Typical High $104.71 | Facility | None | $45.71 | $79.43 | $104.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $165.96 | Professional | None | $31.62 | $38.02 | $165.96 |
United Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $39.81 | Professional | None | $35.48 | $35.48 | $39.81 |
Well Sense Setting Facility Modifier None Typical Low $38.90 Median $47.86 Typical High $74.13 | Facility | None | $38.90 | $47.86 | $74.13 |
Well Sense Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $42.66 | Professional | None | $31.62 | $31.62 | $42.66 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where Massachusetts sits
The same service costs 1.7 times more in Hawaii than in Kentucky. 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
$35.48
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.