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 $2.88 Median $2.88 Typical High $13.18 | Facility | None | $2.88 | $2.88 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $13.18 | Professional | None | $2.88 | $2.88 | $13.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $6.17 Median $6.31 Typical High $21.38 | Facility | None | $6.17 | $6.31 | $21.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.57 Median $6.76 Typical High $33.88 | Professional | None | $2.57 | $6.76 | $33.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $4.17 Median $4.68 Typical High $4.68 | Professional | None | $4.17 | $4.68 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.68 | Professional | None | $3.39 | $3.39 | $4.68 |
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 $2.51 Median $5.75 Typical High $6.03 | Professional | None | $2.51 | $5.75 | $6.03 |
Health New England Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.17 Median $6.31 Typical High $21.38 | Facility | None | $6.17 | $6.31 | $21.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.57 Median $6.76 Typical High $33.88 | Professional | None | $2.57 | $6.76 | $33.88 |
Tufts Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.50 | Professional | None | $4.27 | $4.27 | $5.50 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.31 Typical High $6.46 | Professional | None | $2.19 | $3.31 | $6.46 |
Well Sense Setting Facility Modifier None Typical Low $5.50 Median $7.24 Typical High $10.96 | Facility | None | $5.50 | $7.24 | $10.96 |
Well Sense Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.13 | Professional | None | $4.27 | $4.27 | $5.13 |
4 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 52 · Reduced service Typical Low $1.45 Median $1.45 Typical High $6.61 | Professional | 52 · Reduced service | $1.45 | $1.45 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $2.63 | Professional | 53 · Discontinued | $0.58 | $0.58 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $2.00 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $1.32 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $1.32 |
Where Massachusetts sits
The same service costs 2.1 times more in Kansas than in Alabama. 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· 22nd of 51
$4.68
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.