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 $2.09 Median $2.09 Typical High $9.55 | Facility | None | $2.09 | $2.09 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $9.55 | Professional | None | $2.09 | $2.09 | $9.55 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4.57 Median $4.90 Typical High $41.69 | Facility | None | $4.57 | $4.90 | $41.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.04 Median $4.90 Typical High $23.99 | Professional | None | $2.04 | $4.90 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.63 | Professional | None | $2.00 | $2.00 | $2.63 |
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 $1.86 Median $4.17 Typical High $4.68 | Professional | None | $1.86 | $4.17 | $4.68 |
Mass General Brigham Setting Facility Modifier None Typical Low $4.57 Median $4.90 Typical High $41.69 | Facility | None | $4.57 | $4.90 | $41.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.04 Median $4.90 Typical High $23.99 | Professional | None | $2.04 | $4.90 | $23.99 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.40 Typical High $4.68 | Professional | None | $1.58 | $2.40 | $4.68 |
Well Sense Setting Facility Modifier None Typical Low $3.98 Median $5.50 Typical High $8.13 | Facility | None | $3.98 | $5.50 | $8.13 |
Well Sense Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.63 | Professional | None | $3.02 | $3.02 | $3.63 |
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 $1.05 Median $1.05 Typical High $4.68 | Professional | 52 · Reduced service | $1.05 | $1.05 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.42 Typical High $1.91 | Professional | 53 · Discontinued | $0.42 | $0.42 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.31 Typical High $1.41 | Professional | 55 · Aftercare only | $0.31 | $0.31 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.95 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 15th of 51
$3.89
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.