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 $44.67 Median $44.67 Typical High $138.04 | Facility | None | $44.67 | $44.67 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $44.67 Typical High $44.67 | Professional | None | $38.90 | $44.67 | $44.67 |
AllWays Health Partners Setting Facility Modifier None Typical Low $66.07 Median $70.79 Typical High $234.42 | Facility | None | $66.07 | $70.79 | $234.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $34.67 Median $57.54 Typical High $467.74 | Professional | None | $34.67 | $57.54 | $467.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $77.62 Median $91.20 Typical High $120.23 | Facility | None | $77.62 | $91.20 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $34.67 Median $61.66 Typical High $61.66 | Professional | None | $34.67 | $61.66 | $61.66 |
Mass General Brigham Setting Facility Modifier None Typical Low $66.07 Median $70.79 Typical High $234.42 | Facility | None | $66.07 | $70.79 | $234.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $34.67 Median $57.54 Typical High $467.74 | Professional | None | $34.67 | $57.54 | $467.74 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $10.00 Median $34.67 Typical High $41.69 | Professional | None | $10.00 | $34.67 | $41.69 |
Well Sense Setting Facility Modifier None Typical Low $48.98 Median $67.61 Typical High $102.33 | Facility | None | $48.98 | $67.61 | $102.33 |
Well Sense Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $19.50 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $19.50 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.94 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.89 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.89 | $4.47 | $4.47 |
Where Massachusetts sits
The same service costs 3.1 times more in Montana 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· 33rd of 51
$44.67
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.