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 $25.70 Median $25.70 Typical High $37.15 | Facility | None | $25.70 | $25.70 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $26.92 | Professional | None | $25.70 | $25.70 | $26.92 |
AllWays Health Partners Setting Facility Modifier None Typical Low $28.18 Median $38.90 Typical High $85.11 | Facility | None | $28.18 | $38.90 | $85.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $114.82 | Professional | None | $25.70 | $27.54 | $114.82 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $25.70 Median $29.51 Typical High $53.70 | Facility | None | $25.70 | $29.51 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $46.77 Typical High $112.20 | Facility | None | $25.70 | $46.77 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Fallon Health Setting Facility Modifier None Typical Low $30.90 Median $37.15 Typical High $43.65 | Facility | None | $30.90 | $37.15 | $43.65 |
Fallon Health Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $27.54 | Professional | None | $25.70 | $25.70 | $27.54 |
Health New England Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $28.18 Median $38.90 Typical High $85.11 | Facility | None | $28.18 | $38.90 | $85.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $114.82 | Professional | None | $25.70 | $27.54 | $114.82 |
United Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
United Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $28.84 | Professional | None | $25.70 | $25.70 | $28.84 |
Well Sense Setting Facility Modifier None Typical Low $28.18 Median $36.31 Typical High $60.26 | Facility | None | $28.18 | $36.31 | $60.26 |
Well Sense Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
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 $12.88 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.57 |
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· 35th of 51
$25.70
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.