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 $54.95 Median $54.95 Typical High $173.78 | Facility | None | $54.95 | $54.95 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | None | $50.12 | $54.95 | $54.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $83.18 Median $89.13 Typical High $288.40 | Facility | None | $83.18 | $89.13 | $288.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $478.63 | Professional | None | $42.66 | $70.79 | $478.63 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $97.72 Median $112.20 Typical High $151.36 | Facility | None | $97.72 | $112.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
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 $42.66 Median $75.86 Typical High $75.86 | Professional | None | $42.66 | $75.86 | $75.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $83.18 Median $89.13 Typical High $288.40 | Facility | None | $83.18 | $89.13 | $288.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $478.63 | Professional | None | $42.66 | $70.79 | $478.63 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $12.02 Median $42.66 Typical High $52.48 | Professional | None | $12.02 | $42.66 | $52.48 |
Well Sense Setting Facility Modifier None Typical Low $61.66 Median $85.11 Typical High $125.89 | Facility | None | $61.66 | $85.11 | $125.89 |
Well Sense Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $25.12 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $25.12 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.00 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $7.41 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.01 | $5.50 | $5.50 |
Where Massachusetts sits
The same service costs 2.4 times more in Hawaii 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· 33rd 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.