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 $9.33 Median $9.33 Typical High $42.66 | Facility | None | $9.33 | $9.33 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $42.66 | Professional | None | $9.33 | $9.33 | $42.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $19.95 Median $20.42 Typical High $66.07 | Facility | None | $19.95 | $20.42 | $66.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $8.32 Median $21.88 Typical High $112.20 | Professional | None | $8.32 | $21.88 | $112.20 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $41.69 | Facility | None | $13.80 | $13.80 | $41.69 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $13.49 Median $13.80 Typical High $13.80 | Professional | None | $13.49 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $13.49 | Facility | None | $9.55 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
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 $7.41 Median $18.62 Typical High $20.89 | Professional | None | $7.41 | $18.62 | $20.89 |
Health New England Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $19.95 Median $20.42 Typical High $66.07 | Facility | None | $19.95 | $20.42 | $66.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $8.32 Median $21.88 Typical High $112.20 | Professional | None | $8.32 | $21.88 | $112.20 |
Tufts Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $17.78 | Professional | None | $13.49 | $13.49 | $17.78 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.47 Typical High $20.89 | Professional | None | $7.08 | $10.47 | $20.89 |
Well Sense Setting Facility Modifier None Typical Low $17.78 Median $23.44 Typical High $34.67 | Facility | None | $17.78 | $23.44 | $34.67 |
Well Sense Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $16.22 | Professional | None | $13.49 | $13.49 | $16.22 |
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 $1.38 Median $1.38 Typical High $6.31 | Professional | 55 · Aftercare only | $1.38 | $1.38 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $0.93 Typical High $4.27 | Professional | 56 · Pre-op care only | $0.93 | $0.93 | $4.27 |
Where Massachusetts sits
The same service costs 2.8 times more in Hawaii than in Connecticut. 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· 22nd of 51
$13.80
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.