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 $69.18 Median $69.18 Typical High $218.78 | Facility | None | $69.18 | $69.18 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $69.18 | Professional | None | $56.23 | $69.18 | $69.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $102.33 Median $109.65 Typical High $363.08 | Facility | None | $102.33 | $109.65 | $363.08 |
AllWays Health Partners Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $645.65 | Professional | None | $53.70 | $89.13 | $645.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $186.21 | Facility | None | $120.23 | $141.25 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $48.98 Median $95.50 Typical High $95.50 | Professional | None | $48.98 | $95.50 | $95.50 |
Mass General Brigham Setting Facility Modifier None Typical Low $102.33 Median $109.65 Typical High $363.08 | Facility | None | $102.33 | $109.65 | $363.08 |
Mass General Brigham Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $645.65 | Professional | None | $53.70 | $89.13 | $645.65 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $15.14 Median $53.70 Typical High $64.57 | Professional | None | $15.14 | $53.70 | $64.57 |
Well Sense Setting Facility Modifier None Typical Low $77.62 Median $107.15 Typical High $158.49 | Facility | None | $77.62 | $107.15 | $158.49 |
Well Sense Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $11.22 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $6.92 | $6.92 |
Where Massachusetts sits
The same service costs 2.5 times more in Montana than in Missouri. 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
$69.18
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.