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 $147.91 Median $147.91 Typical High $467.74 | Facility | None | $147.91 | $147.91 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | None | $123.03 | $147.91 | $147.91 |
AllWays Health Partners Setting Facility Modifier None Typical Low $223.87 Median $239.88 Typical High $549.54 | Facility | None | $223.87 | $239.88 | $549.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $1,819.70 | Professional | None | $112.20 | $194.98 | $1,819.70 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $263.03 Median $309.03 Typical High $407.38 | Facility | None | $263.03 | $309.03 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $104.71 Median $204.17 Typical High $204.17 | Professional | None | $104.71 | $204.17 | $204.17 |
Mass General Brigham Setting Facility Modifier None Typical Low $223.87 Median $239.88 Typical High $549.54 | Facility | None | $223.87 | $239.88 | $549.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $1,819.70 | Professional | None | $112.20 | $194.98 | $1,819.70 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
United Setting Professional Modifier None Typical Low $15.14 Median $117.49 Typical High $141.25 | Professional | None | $15.14 | $117.49 | $141.25 |
Well Sense Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $338.84 | Facility | None | $165.96 | $229.09 | $338.84 |
Well Sense Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $61.66 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $24.55 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $14.79 |
Where Massachusetts sits
The same service costs 5.0 times more in Hawaii than in Florida. 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
$148
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.