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 $38.02 Median $38.02 Typical High $120.23 | Facility | None | $38.02 | $38.02 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | None | $38.02 | $38.02 | $39.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $56.23 Median $60.26 Typical High $199.53 | Facility | None | $56.23 | $60.26 | $199.53 |
AllWays Health Partners Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $371.54 | Professional | None | $29.51 | $51.29 | $371.54 |
BCBS Setting Facility Modifier None Typical Low $66.07 Median $77.62 Typical High $102.33 | Facility | None | $66.07 | $77.62 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
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 $29.51 Median $52.48 Typical High $52.48 | Professional | None | $29.51 | $52.48 | $52.48 |
Mass General Brigham Setting Facility Modifier None Typical Low $56.23 Median $60.26 Typical High $199.53 | Facility | None | $56.23 | $60.26 | $199.53 |
Mass General Brigham Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $371.54 | Professional | None | $29.51 | $51.29 | $371.54 |
United Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
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 $42.66 Median $58.88 Typical High $87.10 | Facility | None | $42.66 | $58.88 | $87.10 |
Well Sense Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $19.05 Median $19.05 Typical High $19.50 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.98 |
Where Massachusetts sits
The same service costs 2.8 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· 36th of 51
$38.02
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.