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 $74.13 Median $74.13 Typical High $234.42 | Facility | None | $74.13 | $74.13 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $74.13 | Professional | None | $60.26 | $74.13 | $74.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $112.20 Median $120.23 Typical High $275.42 | Facility | None | $112.20 | $120.23 | $275.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $52.48 Median $97.72 Typical High $575.44 | Professional | None | $52.48 | $97.72 | $575.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $131.83 Median $151.36 Typical High $204.17 | Facility | None | $131.83 | $151.36 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $52.48 Median $102.33 Typical High $102.33 | Professional | None | $52.48 | $102.33 | $102.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $112.20 Median $120.23 Typical High $275.42 | Facility | None | $112.20 | $120.23 | $275.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $52.48 Median $97.72 Typical High $575.44 | Professional | None | $52.48 | $97.72 | $575.44 |
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 $58.88 Typical High $70.79 | Professional | None | $10.00 | $58.88 | $70.79 |
Well Sense Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $169.82 | Facility | None | $83.18 | $114.82 | $169.82 |
Well Sense Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $30.20 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $30.20 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $12.02 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $9.12 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.03 | $7.41 | $7.41 |
Where Massachusetts sits
The same service costs 3.2 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· 20th of 51
$74.13
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.