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 $70.79 Median $70.79 Typical High $223.87 | Facility | None | $70.79 | $70.79 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | None | $54.95 | $70.79 | $70.79 |
AllWays Health Partners Setting Facility Modifier None Typical Low $107.15 Median $114.82 Typical High $371.54 | Facility | None | $107.15 | $114.82 | $371.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $537.03 | Professional | None | $53.70 | $91.20 | $537.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $125.89 Median $144.54 Typical High $194.98 | Facility | None | $125.89 | $144.54 | $194.98 |
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 $50.12 Median $97.72 Typical High $97.72 | Professional | None | $50.12 | $97.72 | $97.72 |
Mass General Brigham Setting Facility Modifier None Typical Low $107.15 Median $114.82 Typical High $371.54 | Facility | None | $107.15 | $114.82 | $371.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $537.03 | Professional | None | $53.70 | $91.20 | $537.03 |
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 $56.23 Typical High $67.61 | Professional | None | $15.14 | $56.23 | $67.61 |
Well Sense Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $162.18 | Facility | None | $79.43 | $109.65 | $162.18 |
Well Sense Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $27.54 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $27.54 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $10.96 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $8.32 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.50 | $7.08 | $7.08 |
Where Massachusetts sits
The same service costs 2.3 times more in Hawaii than in Utah. 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· 28th of 51
$70.79
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.