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 $0.30 Median $20.42 Typical High $32.36 | Facility | None | $0.30 | $20.42 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $28.18 | Professional | None | $10.00 | $10.00 | $28.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $41.69 Median $46.77 Typical High $63.10 | Facility | None | $41.69 | $46.77 | $63.10 |
AllWays Health Partners Setting Professional Modifier None Typical Low $9.55 Median $14.45 Typical High $43.65 | Professional | None | $9.55 | $14.45 | $43.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $27.54 Median $31.62 Typical High $57.54 | Facility | None | $27.54 | $31.62 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $16.22 Typical High $50.12 | Professional | None | $14.45 | $16.22 | $50.12 |
Fallon Health Setting Facility Modifier None Typical Low $10.72 Median $19.95 Typical High $28.18 | Facility | None | $10.72 | $19.95 | $28.18 |
Fallon Health Setting Professional Modifier None Typical Low $10.47 Median $18.20 Typical High $26.30 | Professional | None | $10.47 | $18.20 | $26.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $56.23 | Professional | None | $12.02 | $18.20 | $56.23 |
Health New England Setting Facility Modifier None Typical Low $30.20 Median $70.79 Typical High $144.54 | Facility | None | $30.20 | $70.79 | $144.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $41.69 Median $46.77 Typical High $63.10 | Facility | None | $41.69 | $46.77 | $63.10 |
Mass General Brigham Setting Professional Modifier None Typical Low $9.55 Median $14.45 Typical High $43.65 | Professional | None | $9.55 | $14.45 | $43.65 |
Tufts Setting Facility Modifier None Typical Low $9.33 Median $9.77 Typical High $524.81 | Facility | None | $9.33 | $9.77 | $524.81 |
United Setting Professional Modifier None Typical Low $8.91 Median $14.45 Typical High $43.65 | Professional | None | $8.91 | $14.45 | $43.65 |
Well Sense Setting Facility Modifier None Typical Low $9.77 Median $13.49 Typical High $20.42 | Facility | None | $9.77 | $13.49 | $20.42 |
Well Sense Setting Professional Modifier None Typical Low $5.89 Median $7.08 Typical High $10.00 | Professional | None | $5.89 | $7.08 | $10.00 |
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 $5.01 Median $5.01 Typical High $10.23 | Professional | 52 · Reduced service | $5.01 | $5.01 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $4.07 | Professional | 53 · Discontinued | $2.00 | $2.00 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $3.09 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $2.04 |
Where Massachusetts sits
The same service costs 5.6 times more in Alabama than in Kentucky. 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
$17.78
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.