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 $33.88 Median $33.88 Typical High $107.15 | Facility | None | $33.88 | $33.88 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | None | $33.88 | $33.88 | $35.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $51.29 Median $54.95 Typical High $125.89 | Facility | None | $51.29 | $54.95 | $125.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $26.92 Median $44.67 Typical High $346.74 | Professional | None | $26.92 | $44.67 | $346.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $60.26 Median $70.79 Typical High $93.33 | Facility | None | $60.26 | $70.79 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
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 $26.92 Median $46.77 Typical High $46.77 | Professional | None | $26.92 | $46.77 | $46.77 |
Mass General Brigham Setting Facility Modifier None Typical Low $51.29 Median $54.95 Typical High $125.89 | Facility | None | $51.29 | $54.95 | $125.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $26.92 Median $44.67 Typical High $346.74 | Professional | None | $26.92 | $44.67 | $346.74 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $10.00 Median $26.92 Typical High $32.36 | Professional | None | $10.00 | $26.92 | $32.36 |
Well Sense Setting Facility Modifier None Typical Low $38.02 Median $52.48 Typical High $77.62 | Facility | None | $38.02 | $52.48 | $77.62 |
Well Sense Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
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 $16.98 Median $16.98 Typical High $17.78 | Professional | 52 · Reduced service | $16.98 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $7.08 | Professional | 53 · Discontinued | $6.92 | $6.92 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.37 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.55 |
Where Massachusetts sits
The same service costs 3.3 times more in Montana than in Indiana. 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
$33.88
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.