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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $13.49 | Professional | None | $10.72 | $10.72 | $13.49 |
AllWays Health Partners Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $81.28 | Facility | None | $25.70 | $25.70 | $81.28 |
AllWays Health Partners Setting Professional Modifier None Typical Low $11.75 Median $25.70 Typical High $128.82 | Professional | None | $11.75 | $25.70 | $128.82 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $25.70 Median $31.62 Typical High $42.66 | Facility | None | $25.70 | $31.62 | $42.66 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.98 | Professional | None | $16.22 | $16.22 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $20.89 | Professional | None | $15.14 | $15.14 | $20.89 |
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 $9.77 Median $21.88 Typical High $24.55 | Professional | None | $9.77 | $21.88 | $24.55 |
Mass General Brigham Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $81.28 | Facility | None | $25.70 | $25.70 | $81.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $11.75 Median $25.70 Typical High $128.82 | Professional | None | $11.75 | $25.70 | $128.82 |
Tufts Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
United Setting Professional Modifier None Typical Low $8.71 Median $13.18 Typical High $24.55 | Professional | None | $8.71 | $13.18 | $24.55 |
Well Sense Setting Facility Modifier None Typical Low $20.89 Median $28.84 Typical High $42.66 | Facility | None | $20.89 | $28.84 | $42.66 |
Well Sense Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $5.37 Median $5.37 Typical High $6.76 | Professional | 52 · Reduced service | $5.37 | $5.37 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $2.69 | Professional | 53 · Discontinued | $2.14 | $2.14 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $2.04 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $1.35 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii 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· 14th of 51
$20.89
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.