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 $46.77 Median $46.77 Typical High $147.91 | Facility | None | $46.77 | $46.77 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $47.86 | Professional | None | $46.77 | $46.77 | $47.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $245.47 | Facility | None | $70.79 | $75.86 | $245.47 |
AllWays Health Partners Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $457.09 | Professional | None | $37.15 | $61.66 | $457.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $83.18 Median $95.50 Typical High $128.82 | Facility | None | $83.18 | $95.50 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
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 $34.67 Median $64.57 Typical High $64.57 | Professional | None | $34.67 | $64.57 | $64.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $245.47 | Facility | None | $70.79 | $75.86 | $245.47 |
Mass General Brigham Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $457.09 | Professional | None | $37.15 | $61.66 | $457.09 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $12.02 Median $37.15 Typical High $44.67 | Professional | None | $12.02 | $37.15 | $44.67 |
Well Sense Setting Facility Modifier None Typical Low $52.48 Median $72.44 Typical High $107.15 | Facility | None | $52.48 | $72.44 | $107.15 |
Well Sense Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $23.44 Median $23.44 Typical High $23.99 | Professional | 52 · Reduced service | $23.44 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $9.55 | Professional | 53 · Discontinued | $9.33 | $9.33 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $4.79 |
Where Massachusetts sits
The same service costs 2.9 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
$46.77
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.