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 $234.42 Median $234.42 Typical High $724.44 | Facility | None | $234.42 | $234.42 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $234.42 | Professional | None | $190.55 | $234.42 | $234.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $371.54 Typical High $691.83 | Facility | None | $346.74 | $371.54 | $691.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $181.97 Median $302.00 Typical High $2,454.71 | Professional | None | $181.97 | $302.00 | $2,454.71 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $181.97 Median $316.23 Typical High $316.23 | Professional | None | $181.97 | $316.23 | $316.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $371.54 Typical High $691.83 | Facility | None | $346.74 | $371.54 | $691.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $181.97 Median $302.00 Typical High $2,454.71 | Professional | None | $181.97 | $302.00 | $2,454.71 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $245.47 | Professional | None | $120.23 | $181.97 | $245.47 |
Well Sense Setting Facility Modifier None Typical Low $295.12 Median $407.38 Typical High $602.56 | Facility | None | $295.12 | $407.38 | $602.56 |
Well Sense Setting Professional Modifier None Typical Low $575.44 Median $2,511.89 Typical High $3,019.95 | Professional | None | $575.44 | $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 $95.50 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $38.02 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $28.84 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $23.44 |
Where Massachusetts sits
The same service costs 4.4 times more in Hawaii 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· 33rd of 51
$234
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.