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 $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $7.76 | Professional | None | $1.23 | $1.23 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $1.17 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $39.81 Median $43.65 Typical High $54.95 | Facility | None | $39.81 | $43.65 | $54.95 |
AllWays Health Partners Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $13.80 | Professional | None | $10.00 | $12.88 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $14.13 Typical High $17.78 | Professional | None | $13.80 | $14.13 | $17.78 |
Fallon Health Setting Facility Modifier None Typical Low $26.30 Median $32.36 Typical High $38.90 | Facility | None | $26.30 | $32.36 | $38.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $12.88 | Professional | None | $10.00 | $10.00 | $12.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $39.81 Median $43.65 Typical High $54.95 | Facility | None | $39.81 | $43.65 | $54.95 |
Mass General Brigham Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $13.80 | Professional | None | $10.00 | $12.88 | $13.80 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $12.88 | Professional | None | $10.00 | $10.00 | $12.88 |
1 more rate 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 |
|---|---|---|---|---|---|
Well Sense Setting Facility Modifier SE · Publicly funded program Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | SE · Publicly funded program | $524.81 | $524.81 | $524.81 |
Where Massachusetts sits
The same service costs 331.1 times more in New Jersey than in New York. 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· 49th of 51
$1.23
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.