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 $33.11 Median $33.11 Typical High $104.71 | Facility | None | $33.11 | $33.11 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $35.48 | Professional | None | $33.11 | $33.11 | $35.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $48.98 Median $52.48 Typical High $173.78 | Facility | None | $48.98 | $52.48 | $173.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $25.70 Median $44.67 Typical High $338.84 | Professional | None | $25.70 | $44.67 | $338.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $58.88 Median $67.61 Typical High $89.13 | Facility | None | $58.88 | $67.61 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
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 $25.70 Median $45.71 Typical High $45.71 | Professional | None | $25.70 | $45.71 | $45.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $48.98 Median $52.48 Typical High $173.78 | Facility | None | $48.98 | $52.48 | $173.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $25.70 Median $44.67 Typical High $338.84 | Professional | None | $25.70 | $44.67 | $338.84 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $10.00 Median $25.70 Typical High $32.36 | Professional | None | $10.00 | $25.70 | $32.36 |
Well Sense Setting Facility Modifier None Typical Low $37.15 Median $51.29 Typical High $75.86 | Facility | None | $37.15 | $51.29 | $75.86 |
Well Sense Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $16.60 Median $16.60 Typical High $17.78 | Professional | 52 · Reduced service | $16.60 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $7.08 | Professional | 53 · Discontinued | $6.61 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.37 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.55 |
Where Massachusetts sits
The same service costs 3.0 times more in Hawaii 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· 39th of 51
$33.11
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.