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 $2.09 Median $2.09 Typical High $9.55 | Facility | None | $2.09 | $2.09 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $9.55 | Professional | None | $2.09 | $2.09 | $9.55 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4.37 Median $4.57 Typical High $15.49 | Facility | None | $4.37 | $4.57 | $15.49 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.86 Median $4.90 Typical High $28.84 | Professional | None | $1.86 | $4.90 | $28.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $3.02 Median $3.39 Typical High $3.39 | Professional | None | $3.02 | $3.39 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $3.09 | Facility | None | $2.88 | $2.88 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.39 | Professional | None | $2.45 | $2.45 | $3.39 |
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 $1.82 Median $4.17 Typical High $4.37 | Professional | None | $1.82 | $4.17 | $4.37 |
Health New England Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $4.37 Median $4.57 Typical High $15.49 | Facility | None | $4.37 | $4.57 | $15.49 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.86 Median $4.90 Typical High $28.84 | Professional | None | $1.86 | $4.90 | $28.84 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.40 Typical High $4.68 | Professional | None | $1.58 | $2.40 | $4.68 |
Well Sense Setting Facility Modifier None Typical Low $3.98 Median $5.25 Typical High $7.76 | Facility | None | $3.98 | $5.25 | $7.76 |
Well Sense Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.63 | Professional | None | $3.02 | $3.02 | $3.63 |
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 $0.31 Median $0.31 Typical High $1.41 | Professional | 55 · Aftercare only | $0.31 | $0.31 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.95 |
Where Massachusetts sits
The same service costs 2.8 times more in Kansas than in Delaware. 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
$3.39
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.