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 $46.77 Median $46.77 Typical High $144.54 | Facility | None | $46.77 | $46.77 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $46.77 | Professional | None | $38.02 | $46.77 | $46.77 |
AllWays Health Partners Setting Facility Modifier None Typical Low $69.18 Median $74.13 Typical High $245.47 | Facility | None | $69.18 | $74.13 | $245.47 |
AllWays Health Partners Setting Professional Modifier None Typical Low $36.31 Median $63.10 Typical High $489.78 | Professional | None | $36.31 | $63.10 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
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 $36.31 Median $64.57 Typical High $64.57 | Professional | None | $36.31 | $64.57 | $64.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $69.18 Median $74.13 Typical High $245.47 | Facility | None | $69.18 | $74.13 | $245.47 |
Mass General Brigham Setting Professional Modifier None Typical Low $36.31 Median $63.10 Typical High $489.78 | Professional | None | $36.31 | $63.10 | $489.78 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $44.67 | Professional | None | $24.55 | $36.31 | $44.67 |
Well Sense Setting Facility Modifier None Typical Low $58.88 Median $81.28 Typical High $120.23 | Facility | None | $58.88 | $81.28 | $120.23 |
Well Sense Setting Professional Modifier None Typical Low $114.82 Median $2,511.89 Typical High $3,019.95 | Professional | None | $114.82 | $2,511.89 | $3,019.95 |
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 $19.05 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $19.05 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $7.76 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $5.75 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.80 | $4.68 | $4.68 |
Where Massachusetts sits
The same service costs 2.8 times more in Montana than in Alabama. 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· 36th of 51
$46.77
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.