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 $977.24 Median $977.24 Typical High $3,090.30 | Facility | None | $977.24 | $977.24 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | None | $954.99 | $977.24 | $977.24 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,884.03 | Facility | None | $1,479.11 | $1,584.89 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $776.25 Median $1,288.25 Typical High $10,471.29 | Professional | None | $776.25 | $1,288.25 | $10,471.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,737.80 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $776.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $776.25 | $1,348.96 | $1,348.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,884.03 | Facility | None | $1,479.11 | $1,584.89 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $776.25 Median $1,288.25 Typical High $10,471.29 | Professional | None | $776.25 | $1,288.25 | $10,471.29 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
United Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,023.29 | Professional | None | $512.86 | $776.25 | $1,023.29 |
Well Sense Setting Facility Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,570.40 | Facility | None | $1,230.27 | $1,698.24 | $2,570.40 |
Well Sense Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,023.29 | $2,398.83 |
5 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 $478.63 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $190.55 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $97.72 |
BCBS Massachusetts Setting Professional Modifier RA · Replacement item Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | RA · Replacement item | $758.58 | $758.58 | $758.58 |
Where Massachusetts sits
The same service costs 2.7 times more in Montana than in New Jersey. 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· 34th of 51
$977
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.