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 Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | None | $120.23 | $120.23 | $151.36 |
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 |
Well Sense Setting Facility Modifier None Typical Low $2,454.71 Median $3,311.31 Typical High $5,128.61 | Facility | None | $2,454.71 | $3,311.31 | $5,128.61 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
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 $3.63 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.72 |
Where Massachusetts sits
The same service costs 125892.5 times more in Massachusetts 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· 1st of 51
$2,512
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.