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 $3.63 Median $3.63 Typical High $16.60 | Facility | None | $3.63 | $3.63 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $16.60 | Professional | None | $3.63 | $3.63 | $16.60 |
AllWays Health Partners Setting Facility Modifier None Typical Low $7.76 Median $7.94 Typical High $26.92 | Facility | None | $7.76 | $7.94 | $26.92 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.24 Median $8.51 Typical High $42.66 | Professional | None | $3.24 | $8.51 | $42.66 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $5.25 Median $5.89 Typical High $5.89 | Professional | None | $5.25 | $5.89 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.37 | Facility | None | $5.01 | $5.01 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.89 | Professional | None | $4.27 | $4.27 | $5.89 |
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 $3.16 Median $7.41 Typical High $7.59 | Professional | None | $3.16 | $7.41 | $7.59 |
Health New England Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
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 $7.76 Median $7.94 Typical High $26.92 | Facility | None | $7.76 | $7.94 | $26.92 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.24 Median $8.51 Typical High $42.66 | Professional | None | $3.24 | $8.51 | $42.66 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.17 Typical High $8.13 | Professional | None | $2.75 | $4.17 | $8.13 |
Well Sense Setting Facility Modifier None Typical Low $6.92 Median $9.33 Typical High $13.80 | Facility | None | $6.92 | $9.33 | $13.80 |
Well Sense Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $6.46 | Professional | None | $5.37 | $5.37 | $6.46 |
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 $0.55 Median $0.55 Typical High $2.51 | Professional | 55 · Aftercare only | $0.55 | $0.55 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.37 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.37 | $0.37 | $1.70 |
Where Massachusetts sits
The same service costs 2.1 times more in Hawaii 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
$5.89
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.