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 $2.82 Median $2.82 Typical High $12.88 | Facility | None | $2.82 | $2.82 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $12.88 | Professional | None | $2.82 | $2.82 | $12.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $5.89 Median $6.17 Typical High $20.89 | Facility | None | $5.89 | $6.17 | $20.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.51 Median $6.61 Typical High $33.11 | Professional | None | $2.51 | $6.61 | $33.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $13.18 | Facility | None | $4.37 | $4.37 | $13.18 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $4.07 Median $4.57 Typical High $4.57 | Professional | None | $4.07 | $4.57 | $4.57 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.17 | Facility | None | $3.89 | $3.89 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.57 | Professional | None | $3.31 | $3.31 | $4.57 |
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 $2.45 Median $5.62 Typical High $5.89 | Professional | None | $2.45 | $5.62 | $5.89 |
Health New England Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Mass General Brigham Setting Facility Modifier None Typical Low $5.89 Median $6.17 Typical High $20.89 | Facility | None | $5.89 | $6.17 | $20.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.51 Median $6.61 Typical High $33.11 | Professional | None | $2.51 | $6.61 | $33.11 |
United Setting Professional Modifier None Typical Low $2.14 Median $3.24 Typical High $6.31 | Professional | None | $2.14 | $3.24 | $6.31 |
Well Sense Setting Facility Modifier None Typical Low $5.37 Median $7.08 Typical High $10.72 | Facility | None | $5.37 | $7.08 | $10.72 |
Well Sense Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.90 | Professional | None | $4.07 | $4.07 | $4.90 |
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 $0.42 Median $0.42 Typical High $1.95 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $1.29 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $1.29 |
Where Massachusetts sits
The same service costs 2.6 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· 21st of 51
$4.57
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.