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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $22.39 | Professional | None | $19.50 | $19.50 | $22.39 |
AllWays Health Partners Setting Facility Modifier None Typical Low $19.50 Median $48.98 Typical High $63.10 | Facility | None | $19.50 | $48.98 | $63.10 |
AllWays Health Partners Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $33.88 | Professional | None | $19.50 | $22.91 | $33.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $21.88 Median $24.55 Typical High $44.67 | Facility | None | $21.88 | $24.55 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $44.67 Typical High $93.33 | Facility | None | $27.54 | $44.67 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $26.92 | Professional | None | $21.38 | $21.38 | $26.92 |
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 $18.20 Median $22.91 Typical High $34.67 | Professional | None | $18.20 | $22.91 | $34.67 |
Mass General Brigham Setting Facility Modifier None Typical Low $19.50 Median $48.98 Typical High $63.10 | Facility | None | $19.50 | $48.98 | $63.10 |
Mass General Brigham Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $33.88 | Professional | None | $19.50 | $22.91 | $33.88 |
United Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
United Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $34.67 | Professional | None | $22.91 | $22.91 | $34.67 |
Well Sense Setting Facility Modifier None Typical Low $31.62 Median $3,090.30 Typical High $4,897.79 | Facility | None | $31.62 | $3,090.30 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $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 $9.77 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $1.95 |
Where Massachusetts sits
The same service costs 2.0 times more in Alabama than in Connecticut. 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· 13th of 51
$22.91
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.