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 $37.15 Median $37.15 Typical High $117.49 | Facility | None | $37.15 | $37.15 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $56.23 Median $60.26 Typical High $194.98 | Facility | None | $56.23 | $60.26 | $194.98 |
AllWays Health Partners Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $354.81 | Professional | None | $29.51 | $51.29 | $354.81 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $66.07 Median $75.86 Typical High $102.33 | Facility | None | $66.07 | $75.86 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
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 $27.54 Median $51.29 Typical High $51.29 | Professional | None | $27.54 | $51.29 | $51.29 |
Mass General Brigham Setting Facility Modifier None Typical Low $56.23 Median $60.26 Typical High $194.98 | Facility | None | $56.23 | $60.26 | $194.98 |
Mass General Brigham Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $354.81 | Professional | None | $29.51 | $51.29 | $354.81 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $10.00 Median $29.51 Typical High $35.48 | Professional | None | $10.00 | $29.51 | $35.48 |
Well Sense Setting Facility Modifier None Typical Low $41.69 Median $57.54 Typical High $85.11 | Facility | None | $41.69 | $57.54 | $85.11 |
Well Sense Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 17th of 51
$47.86
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.