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 $39.81 Median $39.81 Typical High $125.89 | Facility | None | $39.81 | $39.81 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $42.66 | Professional | None | $39.81 | $39.81 | $42.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $60.26 Median $64.57 Typical High $147.91 | Facility | None | $60.26 | $64.57 | $147.91 |
AllWays Health Partners Setting Professional Modifier None Typical Low $31.62 Median $51.29 Typical High $426.58 | Professional | None | $31.62 | $51.29 | $426.58 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $70.79 Median $81.28 Typical High $109.65 | Facility | None | $70.79 | $81.28 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $31.62 Median $54.95 Typical High $54.95 | Professional | None | $31.62 | $54.95 | $54.95 |
Mass General Brigham Setting Facility Modifier None Typical Low $60.26 Median $64.57 Typical High $147.91 | Facility | None | $60.26 | $64.57 | $147.91 |
Mass General Brigham Setting Professional Modifier None Typical Low $31.62 Median $51.29 Typical High $426.58 | Professional | None | $31.62 | $51.29 | $426.58 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $15.14 Median $31.62 Typical High $41.69 | Professional | None | $15.14 | $31.62 | $41.69 |
Well Sense Setting Facility Modifier None Typical Low $44.67 Median $61.66 Typical High $91.20 | Facility | None | $44.67 | $61.66 | $91.20 |
Well Sense Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $19.95 Median $19.95 Typical High $21.38 | Professional | 52 · Reduced service | $19.95 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $8.71 | Professional | 53 · Discontinued | $7.94 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.46 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.27 |
Where Massachusetts sits
The same service costs 4.2 times more in Minnesota than in Alaska. 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· 40th of 51
$39.81
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.