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 $0.83 Median $0.83 Typical High $3.80 | Facility | None | $0.83 | $0.83 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $3.80 | Professional | None | $0.83 | $0.83 | $3.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.82 Median $2.09 Typical High $5.89 | Facility | None | $1.82 | $2.09 | $5.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.74 Median $1.95 Typical High $23.44 | Professional | None | $0.74 | $1.95 | $23.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $3.72 | Facility | None | $1.23 | $1.23 | $3.72 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1.20 Median $1.35 Typical High $1.35 | Professional | None | $1.20 | $1.35 | $1.35 |
Cigna Setting Facility Modifier None Typical Low $0.72 Median $1.35 Typical High $1.35 | Facility | None | $0.72 | $1.35 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.58 | Professional | None | $1.12 | $1.12 | $1.58 |
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 $0.74 Median $1.66 Typical High $1.74 | Professional | None | $0.74 | $1.66 | $1.74 |
Health New England Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | None | $0.43 | $0.43 | $0.43 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.82 Median $2.09 Typical High $5.89 | Facility | None | $1.82 | $2.09 | $5.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.74 Median $1.95 Typical High $23.44 | Professional | None | $0.74 | $1.95 | $23.44 |
Tufts Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.58 | Professional | None | $1.23 | $1.23 | $1.58 |
United Setting Professional Modifier None Typical Low $0.63 Median $0.95 Typical High $1.86 | Professional | None | $0.63 | $0.95 | $1.86 |
Well Sense Setting Facility Modifier None Typical Low $1.58 Median $2.14 Typical High $3.09 | Facility | None | $1.58 | $2.14 | $3.09 |
Well Sense Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.45 | Professional | None | $1.23 | $1.23 | $1.45 |
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 $0.12 Median $0.12 Typical High $0.56 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.38 |
Where Massachusetts sits
The same service costs 5.8 times more in Hawaii than in Rhode Island. 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· 27th of 51
$1.35
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.