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 $151.36 | Facility | None | $48.98 | $48.98 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | None | $45.71 | $48.98 | $48.98 |
AllWays Health Partners Setting Facility Modifier None Typical Low $72.44 Median $77.62 Typical High $251.19 | Facility | None | $72.44 | $77.62 | $251.19 |
AllWays Health Partners Setting Professional Modifier None Typical Low $38.02 Median $63.10 Typical High $446.68 | Professional | None | $38.02 | $63.10 | $446.68 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $85.11 Median $100.00 Typical High $131.83 | Facility | None | $85.11 | $100.00 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
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 $36.31 Median $66.07 Typical High $66.07 | Professional | None | $36.31 | $66.07 | $66.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $72.44 Median $77.62 Typical High $251.19 | Facility | None | $72.44 | $77.62 | $251.19 |
Mass General Brigham Setting Professional Modifier None Typical Low $38.02 Median $63.10 Typical High $446.68 | Professional | None | $38.02 | $63.10 | $446.68 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $12.02 Median $38.02 Typical High $45.71 | Professional | None | $12.02 | $38.02 | $45.71 |
Well Sense Setting Facility Modifier None Typical Low $53.70 Median $74.13 Typical High $112.20 | Facility | None | $53.70 | $74.13 | $112.20 |
Well Sense Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
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 $22.91 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $22.91 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.12 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $6.92 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.57 | $4.79 | $4.79 |
Where Massachusetts sits
The same service costs 2.9 times more in Hawaii than in Indiana. 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· 33rd 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.