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 $12.30 Median $12.30 Typical High $47.86 | Facility | None | $12.30 | $12.30 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $13.49 | Professional | None | $12.30 | $12.30 | $13.49 |
AllWays Health Partners Setting Professional Modifier None Typical Low $10.47 Median $20.42 Typical High $295.12 | Professional | None | $10.47 | $20.42 | $295.12 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $134.90 | Facility | None | $87.10 | $100.00 | $134.90 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $18.20 Typical High $28.84 | Professional | None | $14.79 | $18.20 | $28.84 |
Fallon Health Setting Facility Modifier None Typical Low $8.71 Median $14.79 Typical High $21.38 | Facility | None | $8.71 | $14.79 | $21.38 |
Fallon Health Setting Professional Modifier None Typical Low $8.71 Median $15.14 Typical High $22.91 | Professional | None | $8.71 | $15.14 | $22.91 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.47 Median $14.79 Typical High $33.88 | Professional | None | $10.47 | $14.79 | $33.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $10.47 Median $20.42 Typical High $295.12 | Professional | None | $10.47 | $20.42 | $295.12 |
United Setting Facility Modifier None Typical Low $83.18 Median $154.88 Typical High $234.42 | Facility | None | $83.18 | $154.88 | $234.42 |
United Setting Professional Modifier None Typical Low $8.71 Median $15.85 Typical High $22.39 | Professional | None | $8.71 | $15.85 | $22.39 |
Well Sense Setting Facility Modifier None Typical Low $9.33 Median $12.88 Typical High $19.05 | Facility | None | $9.33 | $12.88 | $19.05 |
Well Sense Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.13 | Professional | None | $10.47 | $10.47 | $14.13 |
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 $6.03 Median $6.03 Typical High $6.76 | Professional | 52 · Reduced service | $6.03 | $6.03 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $2.69 | Professional | 53 · Discontinued | $2.45 | $2.45 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $2.04 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.35 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska 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· 11th of 51
$15.14
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.