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 $4.27 Median $4.27 Typical High $19.50 | Facility | None | $4.27 | $4.27 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $19.50 | Professional | None | $4.27 | $4.27 | $19.50 |
AllWays Health Partners Setting Facility Modifier None Typical Low $9.12 Median $9.55 Typical High $38.02 | Facility | None | $9.12 | $9.55 | $38.02 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.80 Median $10.00 Typical High $50.12 | Professional | None | $3.80 | $10.00 | $50.12 |
BCBS Setting Professional Modifier None Typical Low $5.75 Median $6.46 Typical High $6.46 | Professional | None | $5.75 | $6.46 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $5.62 Median $5.89 Typical High $6.31 | Facility | None | $5.62 | $5.89 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $6.92 | Professional | None | $5.01 | $5.01 | $6.92 |
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 $3.72 Median $8.51 Typical High $9.55 | Professional | None | $3.72 | $8.51 | $9.55 |
Health New England Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Health New England Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Mass General Brigham Setting Facility Modifier None Typical Low $9.12 Median $9.55 Typical High $38.02 | Facility | None | $9.12 | $9.55 | $38.02 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.80 Median $10.00 Typical High $50.12 | Professional | None | $3.80 | $10.00 | $50.12 |
Tufts Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $8.13 | Professional | None | $6.31 | $6.31 | $8.13 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.90 Typical High $9.55 | Professional | None | $3.24 | $4.90 | $9.55 |
Well Sense Setting Facility Modifier None Typical Low $8.13 Median $10.72 Typical High $16.22 | Facility | None | $8.13 | $10.72 | $16.22 |
Well Sense Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
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 $0.65 Median $0.65 Typical High $2.95 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $1.95 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $1.95 |
Where Massachusetts sits
The same service costs 2.4 times more in Kansas 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· 23rd of 51
$6.46
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.