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 $48.98 Median $48.98 Typical High $154.88 | Facility | None | $48.98 | $48.98 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | None | $48.98 | $48.98 | $50.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $257.04 | Facility | None | $74.13 | $79.43 | $257.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $38.90 Median $63.10 Typical High $489.78 | Professional | None | $38.90 | $63.10 | $489.78 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $134.90 | Facility | None | $87.10 | $100.00 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
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 $37.15 Median $67.61 Typical High $67.61 | Professional | None | $37.15 | $67.61 | $67.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $257.04 | Facility | None | $74.13 | $79.43 | $257.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $38.90 Median $63.10 Typical High $489.78 | Professional | None | $38.90 | $63.10 | $489.78 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $10.00 Median $38.90 Typical High $46.77 | Professional | None | $10.00 | $38.90 | $46.77 |
Well Sense Setting Facility Modifier None Typical Low $54.95 Median $75.86 Typical High $112.20 | Facility | None | $54.95 | $75.86 | $112.20 |
Well Sense Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $24.55 Median $24.55 Typical High $25.12 | Professional | 52 · Reduced service | $24.55 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $10.00 | Professional | 53 · Discontinued | $9.77 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.59 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $5.01 |
Where Massachusetts sits
The same service costs 2.6 times more in Montana than in Nebraska. 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· 34th of 51
$48.98
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.