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 $91.20 Median $91.20 Typical High $288.40 | Facility | None | $91.20 | $91.20 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $91.20 | Professional | None | $66.07 | $91.20 | $91.20 |
AllWays Health Partners Setting Facility Modifier None Typical Low $138.04 Median $147.91 Typical High $338.84 | Facility | None | $138.04 | $147.91 | $338.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $794.33 | Professional | None | $64.57 | $117.49 | $794.33 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $162.18 Median $186.21 Typical High $245.47 | Facility | None | $162.18 | $186.21 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
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 $64.57 Median $125.89 Typical High $125.89 | Professional | None | $64.57 | $125.89 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $138.04 Median $147.91 Typical High $338.84 | Facility | None | $138.04 | $147.91 | $338.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $794.33 | Professional | None | $64.57 | $117.49 | $794.33 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $15.14 Median $70.79 Typical High $87.10 | Professional | None | $15.14 | $70.79 | $87.10 |
Well Sense Setting Facility Modifier None Typical Low $102.33 Median $141.25 Typical High $208.93 | Facility | None | $102.33 | $141.25 | $208.93 |
Well Sense Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $32.36 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $32.36 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $13.18 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.61 | $9.12 | $9.12 |
Where Massachusetts sits
The same service costs 4.2 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· 16th of 51
$91.20
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.