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 $0.46 Median $0.46 Typical High $0.46 | Facility | None | $0.46 | $0.46 | $0.46 |
Aetna Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $0.48 | Professional | None | $0.46 | $0.46 | $0.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.41 Median $3.98 Typical High $6.61 | Facility | None | $1.41 | $3.98 | $6.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.43 Median $1.41 Typical High $7.59 | Professional | None | $0.43 | $1.41 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $2.51 | Professional | None | $1.82 | $1.82 | $2.51 |
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 $0.34 Median $1.41 Typical High $1.41 | Professional | None | $0.34 | $1.41 | $1.41 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.41 Median $3.98 Typical High $6.61 | Facility | None | $1.41 | $3.98 | $6.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.43 Median $1.41 Typical High $7.59 | Professional | None | $0.43 | $1.41 | $7.59 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.52 Typical High $0.93 | Professional | None | $0.32 | $0.52 | $0.93 |
Well Sense Setting Facility Modifier None Typical Low $1.26 Median $1.91 Typical High $3.09 | Facility | None | $1.26 | $1.91 | $3.09 |
Well Sense Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.51 | Professional | None | $1.26 | $1.26 | $1.51 |
2 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 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Massachusetts sits
The same service costs 190.5 times more in Wyoming than in Rhode Island. 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· 10th of 51
$1.12
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.