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 $28.84 Median $28.84 Typical High $91.20 | Facility | None | $28.84 | $28.84 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $30.90 | Professional | None | $28.84 | $28.84 | $30.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $42.66 Median $45.71 Typical High $151.36 | Facility | None | $42.66 | $45.71 | $151.36 |
AllWays Health Partners Setting Professional Modifier None Typical Low $22.39 Median $38.90 Typical High $295.12 | Professional | None | $22.39 | $38.90 | $295.12 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $51.29 Median $58.88 Typical High $77.62 | Facility | None | $51.29 | $58.88 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
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 $22.39 Median $39.81 Typical High $39.81 | Professional | None | $22.39 | $39.81 | $39.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $42.66 Median $45.71 Typical High $151.36 | Facility | None | $42.66 | $45.71 | $151.36 |
Mass General Brigham Setting Professional Modifier None Typical Low $22.39 Median $38.90 Typical High $295.12 | Professional | None | $22.39 | $38.90 | $295.12 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $10.00 Median $22.39 Typical High $30.20 | Professional | None | $10.00 | $22.39 | $30.20 |
Well Sense Setting Facility Modifier None Typical Low $32.36 Median $44.67 Typical High $66.07 | Facility | None | $32.36 | $44.67 | $66.07 |
Well Sense Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $14.45 Median $14.45 Typical High $15.49 | Professional | 52 · Reduced service | $14.45 | $14.45 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | 53 · Discontinued | $5.75 | $5.75 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.68 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.09 |
Where Massachusetts sits
The same service costs 3.3 times more in Montana than in Missouri. 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· 37th of 51
$28.84
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.