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 $281.84 Median $281.84 Typical High $891.25 | Facility | None | $281.84 | $281.84 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | None | $234.42 | $281.84 | $281.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $426.58 Median $457.09 Typical High $1,071.52 | Facility | None | $426.58 | $457.09 | $1,071.52 |
AllWays Health Partners Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $3,019.95 | Professional | None | $223.87 | $363.08 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $223.87 Median $389.05 Typical High $389.05 | Professional | None | $223.87 | $389.05 | $389.05 |
Mass General Brigham Setting Facility Modifier None Typical Low $426.58 Median $457.09 Typical High $1,071.52 | Facility | None | $426.58 | $457.09 | $1,071.52 |
Mass General Brigham Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $3,019.95 | Professional | None | $223.87 | $363.08 | $3,019.95 |
United Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
United Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $295.12 | Professional | None | $147.91 | $223.87 | $295.12 |
Well Sense Setting Facility Modifier None Typical Low $354.81 Median $489.78 Typical High $724.44 | Facility | None | $354.81 | $489.78 | $724.44 |
Well Sense Setting Professional Modifier None Typical Low $691.83 Median $2,511.89 Typical High $3,019.95 | Professional | None | $691.83 | $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 $117.49 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $46.77 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.44 | $28.18 | $28.18 |
Where Massachusetts sits
The same service costs 2.8 times more in Montana 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· 36th of 51
$282
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.