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 $2.57 Median $2.57 Typical High $11.75 | Facility | None | $2.57 | $2.57 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $11.75 | Professional | None | $2.57 | $2.57 | $11.75 |
AllWays Health Partners Setting Facility Modifier None Typical Low $5.37 Median $5.62 Typical High $19.05 | Facility | None | $5.37 | $5.62 | $19.05 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.29 Median $6.03 Typical High $29.51 | Professional | None | $2.29 | $6.03 | $29.51 |
BCBS Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $12.02 | Facility | None | $3.98 | $3.98 | $12.02 |
BCBS Setting Professional Modifier None Typical Low $3.72 Median $4.17 Typical High $4.17 | Professional | None | $3.72 | $4.17 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $4.47 | Professional | None | $2.45 | $3.24 | $4.47 |
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 $2.24 Median $5.13 Typical High $5.37 | Professional | None | $2.24 | $5.13 | $5.37 |
Health New England Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Mass General Brigham Setting Facility Modifier None Typical Low $5.37 Median $5.62 Typical High $19.05 | Facility | None | $5.37 | $5.62 | $19.05 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.29 Median $6.03 Typical High $29.51 | Professional | None | $2.29 | $6.03 | $29.51 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.95 Typical High $5.75 | Professional | None | $1.95 | $2.95 | $5.75 |
Well Sense Setting Facility Modifier None Typical Low $4.90 Median $6.46 Typical High $9.55 | Facility | None | $4.90 | $6.46 | $9.55 |
Well Sense Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.47 | Professional | None | $3.72 | $3.72 | $4.47 |
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 $0.38 Median $0.38 Typical High $1.74 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $1.17 |
Where Massachusetts sits
The same service costs 3.2 times more in Kansas 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· 19th of 51
$4.17
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.