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 $56.23 Median $56.23 Typical High $177.83 | Facility | None | $56.23 | $56.23 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | None | $46.77 | $56.23 | $56.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $295.12 | Facility | None | $85.11 | $91.20 | $295.12 |
AllWays Health Partners Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $602.56 | Professional | None | $44.67 | $72.44 | $602.56 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $154.88 | Facility | None | $100.00 | $114.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
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 $44.67 Median $77.62 Typical High $77.62 | Professional | None | $44.67 | $77.62 | $77.62 |
Mass General Brigham Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $295.12 | Facility | None | $85.11 | $91.20 | $295.12 |
Mass General Brigham Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $602.56 | Professional | None | $44.67 | $72.44 | $602.56 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $10.00 Median $44.67 Typical High $53.70 | Professional | None | $10.00 | $44.67 | $53.70 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $87.10 Typical High $128.82 | Facility | None | $63.10 | $87.10 | $128.82 |
Well Sense Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $23.44 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $23.44 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $9.33 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $7.08 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.68 | $5.62 | $5.62 |
Where Massachusetts sits
The same service costs 3.5 times more in Hawaii than in New York. 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
$56.23
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.