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 $4.07 Median $4.07 Typical High $18.62 | Facility | None | $4.07 | $4.07 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $18.62 | Professional | None | $4.07 | $4.07 | $18.62 |
AllWays Health Partners Setting Facility Modifier None Typical Low $8.71 Median $9.12 Typical High $28.84 | Facility | None | $8.71 | $9.12 | $28.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.63 Median $9.33 Typical High $51.29 | Professional | None | $3.63 | $9.33 | $51.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $18.20 | Facility | None | $6.03 | $6.03 | $18.20 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $5.89 Median $6.61 Typical High $6.61 | Professional | None | $5.89 | $6.61 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Facility | None | $6.17 | $6.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.24 | Professional | None | $5.25 | $5.25 | $7.24 |
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 $3.63 Median $8.13 Typical High $8.32 | Professional | None | $3.63 | $8.13 | $8.32 |
Health New England Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $8.71 Median $9.12 Typical High $28.84 | Facility | None | $8.71 | $9.12 | $28.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.63 Median $9.33 Typical High $51.29 | Professional | None | $3.63 | $9.33 | $51.29 |
Tufts Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $7.76 | Professional | None | $5.89 | $5.89 | $7.76 |
United Setting Professional Modifier None Typical Low $3.09 Median $4.57 Typical High $9.12 | Professional | None | $3.09 | $4.57 | $9.12 |
Well Sense Setting Facility Modifier None Typical Low $7.76 Median $10.47 Typical High $15.14 | Facility | None | $7.76 | $10.47 | $15.14 |
Well Sense Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $7.08 | Professional | None | $5.89 | $5.89 | $7.08 |
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 $0.62 Median $0.62 Typical High $2.75 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $1.86 | Professional | 56 · Pre-op care only | $0.40 | $0.40 | $1.86 |
Where Massachusetts sits
The same service costs 2.1 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· 25th of 51
$6.61
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.