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 $75.86 Median $75.86 Typical High $234.42 | Facility | None | $75.86 | $75.86 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $75.86 | Professional | None | $56.23 | $75.86 | $75.86 |
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 $53.70 Median $97.72 Typical High $616.60 | Professional | None | $53.70 | $97.72 | $616.60 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $131.83 Median $154.88 Typical High $204.17 | Facility | None | $131.83 | $154.88 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
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 $53.70 Median $102.33 Typical High $102.33 | Professional | None | $53.70 | $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 $53.70 Median $97.72 Typical High $616.60 | Professional | None | $53.70 | $97.72 | $616.60 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $15.14 Median $58.88 Typical High $70.79 | Professional | None | $15.14 | $58.88 | $70.79 |
Well Sense Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $173.78 | Facility | None | $83.18 | $114.82 | $173.78 |
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 $28.18 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $28.18 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $11.22 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $8.51 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.62 | $7.59 | $7.59 |
Where Massachusetts sits
The same service costs 2.9 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· 21st of 51
$75.86
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.