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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $21.88 | Professional | None | $17.78 | $17.78 | $21.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $51.29 Typical High $112.20 | Facility | None | $45.71 | $51.29 | $112.20 |
AllWays Health Partners Setting Professional Modifier None Typical Low $15.49 Median $30.90 Typical High $64.57 | Professional | None | $15.49 | $30.90 | $64.57 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $39.81 Median $45.71 Typical High $61.66 | Facility | None | $39.81 | $45.71 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $32.36 Typical High $85.11 | Professional | None | $26.30 | $32.36 | $85.11 |
Fallon Health Setting Facility Modifier None Typical Low $30.20 Median $36.31 Typical High $5,888.44 | Facility | None | $30.20 | $36.31 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $36.31 | Professional | None | $30.20 | $30.20 | $36.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $22.39 Median $39.81 Typical High $186.21 | Professional | None | $22.39 | $39.81 | $186.21 |
Mass General Brigham Setting Facility Modifier None Typical Low $45.71 Median $51.29 Typical High $112.20 | Facility | None | $45.71 | $51.29 | $112.20 |
Mass General Brigham Setting Professional Modifier None Typical Low $15.49 Median $30.90 Typical High $64.57 | Professional | None | $15.49 | $30.90 | $64.57 |
United Setting Professional Modifier None Typical Low $26.92 Median $39.81 Typical High $89.13 | Professional | None | $26.92 | $39.81 | $89.13 |
Well Sense Setting Facility Modifier None Typical Low $11.22 Median $3,090.30 Typical High $4,897.79 | Facility | None | $11.22 | $3,090.30 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $18.20 | Professional | None | $15.14 | $15.14 | $18.20 |
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 $8.91 Median $8.91 Typical High $10.96 | Professional | 52 · Reduced service | $8.91 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $4.37 | Professional | 53 · Discontinued | $3.63 | $3.63 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $3.31 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $2.19 |
Where Massachusetts sits
The same service costs 4.3 times more in Alaska than in New York. 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· 4th of 51
$39.81
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.