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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | None | $131.83 | $131.83 | $144.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $134.90 Median $144.54 Typical High $426.58 | Facility | None | $134.90 | $144.54 | $426.58 |
AllWays Health Partners Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $331.13 | Professional | None | $120.23 | $131.83 | $331.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $131.83 Median $151.36 Typical High $275.42 | Facility | None | $131.83 | $151.36 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $239.88 Typical High $575.44 | Facility | None | $120.23 | $239.88 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $416.87 | Professional | None | $131.83 | $131.83 | $416.87 |
Fallon Health Setting Facility Modifier None Typical Low $131.83 Median $169.82 Typical High $199.53 | Facility | None | $131.83 | $169.82 | $199.53 |
Fallon Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $199.53 | Professional | None | $169.82 | $169.82 | $199.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $331.13 | Professional | None | $120.23 | $131.83 | $331.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $134.90 Median $144.54 Typical High $426.58 | Facility | None | $134.90 | $144.54 | $426.58 |
Mass General Brigham Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $331.13 | Professional | None | $120.23 | $131.83 | $331.13 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $371.54 | Professional | None | $120.23 | $125.89 | $371.54 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $194.98 Typical High $309.03 | Facility | None | $131.83 | $194.98 | $309.03 |
Well Sense Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | None | $131.83 | $131.83 | $158.49 |
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 $66.07 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.18 |
Where Massachusetts sits
The same service costs 8.7 times more in Texas than in Kansas. 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· 13th of 51
$141
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.