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 $42.66 Median $42.66 Typical High $134.90 | Facility | None | $42.66 | $42.66 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | None | $42.66 | $42.66 | $45.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $63.10 Median $67.61 Typical High $158.49 | Facility | None | $63.10 | $67.61 | $158.49 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.11 Median $54.95 Typical High $446.68 | Professional | None | $33.11 | $54.95 | $446.68 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $114.82 | Facility | None | $75.86 | $87.10 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
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 $33.11 Median $58.88 Typical High $58.88 | Professional | None | $33.11 | $58.88 | $58.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $63.10 Median $67.61 Typical High $158.49 | Facility | None | $63.10 | $67.61 | $158.49 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.11 Median $54.95 Typical High $446.68 | Professional | None | $33.11 | $54.95 | $446.68 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $10.00 Median $33.11 Typical High $39.81 | Professional | None | $10.00 | $33.11 | $39.81 |
Well Sense Setting Facility Modifier None Typical Low $47.86 Median $66.07 Typical High $97.72 | Facility | None | $47.86 | $66.07 | $97.72 |
Well Sense Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $21.38 Median $21.38 Typical High $22.91 | Professional | 52 · Reduced service | $21.38 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $9.12 | Professional | 53 · Discontinued | $8.51 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.92 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.57 |
Where Massachusetts sits
The same service costs 2.7 times more in Hawaii than in Alabama. 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
$42.66
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.