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 $120.23 Median $120.23 Typical High $380.19 | Facility | None | $120.23 | $120.23 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $120.23 | Professional | None | $87.10 | $120.23 | $120.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $177.83 Median $190.55 Typical High $436.52 | Facility | None | $177.83 | $190.55 | $436.52 |
AllWays Health Partners Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $870.96 | Professional | None | $85.11 | $154.88 | $870.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $323.59 | Facility | None | $208.93 | $245.47 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
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 $85.11 Median $165.96 Typical High $165.96 | Professional | None | $85.11 | $165.96 | $165.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $177.83 Median $190.55 Typical High $436.52 | Facility | None | $177.83 | $190.55 | $436.52 |
Mass General Brigham Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $870.96 | Professional | None | $85.11 | $154.88 | $870.96 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $15.14 Median $93.33 Typical High $112.20 | Professional | None | $15.14 | $93.33 | $112.20 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $269.15 | Facility | None | $131.83 | $181.97 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $43.65 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $17.38 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $13.18 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.71 | $12.02 | $12.02 |
Where Massachusetts sits
The same service costs 3.0 times more in Hawaii than in Indiana. 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· 12th of 51
$120
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.