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 $3.02 Median $3.02 Typical High $13.80 | Facility | None | $3.02 | $3.02 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $13.80 | Professional | None | $3.02 | $3.02 | $13.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $6.31 Median $6.61 Typical High $21.88 | Facility | None | $6.31 | $6.61 | $21.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.69 Median $7.08 Typical High $34.67 | Professional | None | $2.69 | $7.08 | $34.67 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $4.37 Median $4.90 Typical High $4.90 | Professional | None | $4.37 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.47 | Facility | None | $4.17 | $4.17 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.90 | Professional | None | $3.55 | $3.55 | $4.90 |
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 $2.63 Median $6.03 Typical High $6.31 | Professional | None | $2.63 | $6.03 | $6.31 |
Health New England Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Health New England Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.31 Median $6.61 Typical High $21.88 | Facility | None | $6.31 | $6.61 | $21.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.69 Median $7.08 Typical High $34.67 | Professional | None | $2.69 | $7.08 | $34.67 |
Tufts Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $5.75 | Professional | None | $4.37 | $4.37 | $5.75 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.47 Typical High $6.76 | Professional | None | $2.29 | $3.47 | $6.76 |
Well Sense Setting Facility Modifier None Typical Low $5.75 Median $7.59 Typical High $11.22 | Facility | None | $5.75 | $7.59 | $11.22 |
Well Sense Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $5.25 | Professional | None | $4.37 | $4.37 | $5.25 |
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 $0.45 Median $0.45 Typical High $2.04 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $1.38 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $1.38 |
Where Massachusetts sits
The same service costs 2.1 times more in Kansas than in Colorado. 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· 24th of 51
$4.90
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.