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 $13.18 Median $13.18 Typical High $60.26 | Facility | None | $13.18 | $13.18 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $60.26 | Professional | None | $13.18 | $13.18 | $60.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $28.84 Median $30.90 Typical High $93.33 | Facility | None | $28.84 | $30.90 | $93.33 |
AllWays Health Partners Setting Professional Modifier None Typical Low $11.75 Median $30.90 Typical High $177.83 | Professional | None | $11.75 | $30.90 | $177.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $58.88 | Facility | None | $19.50 | $19.50 | $58.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $19.05 Median $19.50 Typical High $19.50 | Professional | None | $19.05 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $21.38 Typical High $21.38 | Facility | None | $12.59 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $25.12 | Professional | None | $18.20 | $18.20 | $25.12 |
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 $11.75 Median $26.30 Typical High $29.51 | Professional | None | $11.75 | $26.30 | $29.51 |
Health New England Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Mass General Brigham Setting Facility Modifier None Typical Low $28.84 Median $30.90 Typical High $93.33 | Facility | None | $28.84 | $30.90 | $93.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $11.75 Median $30.90 Typical High $177.83 | Professional | None | $11.75 | $30.90 | $177.83 |
Tufts Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $25.12 | Professional | None | $19.05 | $19.05 | $25.12 |
United Setting Professional Modifier None Typical Low $10.00 Median $15.14 Typical High $29.51 | Professional | None | $10.00 | $15.14 | $29.51 |
Well Sense Setting Facility Modifier None Typical Low $25.12 Median $33.88 Typical High $48.98 | Facility | None | $25.12 | $33.88 | $48.98 |
Well Sense Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | None | $19.05 | $19.05 | $22.91 |
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 $1.95 Median $1.95 Typical High $8.91 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $6.03 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $6.03 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 23rd of 51
$21.38
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.