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 $131.83 | Facility | None | $42.66 | $42.66 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $63.10 Median $67.61 Typical High $218.78 | Facility | None | $63.10 | $67.61 | $218.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.11 Median $57.54 Typical High $398.11 | Professional | None | $33.11 | $57.54 | $398.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $74.13 Median $87.10 Typical High $114.82 | Facility | None | $74.13 | $87.10 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $30.90 Median $57.54 Typical High $57.54 | Professional | None | $30.90 | $57.54 | $57.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $63.10 Median $67.61 Typical High $218.78 | Facility | None | $63.10 | $67.61 | $218.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.11 Median $57.54 Typical High $398.11 | Professional | None | $33.11 | $57.54 | $398.11 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $12.02 Median $33.11 Typical High $40.74 | Professional | None | $12.02 | $33.11 | $40.74 |
Well Sense Setting Facility Modifier None Typical Low $46.77 Median $64.57 Typical High $97.72 | Facility | None | $46.77 | $64.57 | $97.72 |
Well Sense Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
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 $20.89 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where Massachusetts sits
The same service costs 2.8 times more in Montana than in Ohio. 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· 15th of 51
$54.95
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.