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 $1.70 Median $1.70 Typical High $7.76 | Facility | None | $1.70 | $1.70 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $7.76 | Professional | None | $1.70 | $1.70 | $7.76 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.63 Median $3.72 Typical High $12.59 | Facility | None | $3.63 | $3.72 | $12.59 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.51 Median $3.98 Typical High $19.95 | Professional | None | $1.51 | $3.98 | $19.95 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $2.45 Median $2.75 Typical High $2.75 | Professional | None | $2.45 | $2.75 | $2.75 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.75 | Professional | None | $2.00 | $2.00 | $2.75 |
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 $1.48 Median $3.39 Typical High $3.55 | Professional | None | $1.48 | $3.39 | $3.55 |
Health New England Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Health New England Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.63 Median $3.72 Typical High $12.59 | Facility | None | $3.63 | $3.72 | $12.59 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.51 Median $3.98 Typical High $19.95 | Professional | None | $1.51 | $3.98 | $19.95 |
Tufts Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.24 | Professional | None | $2.45 | $2.45 | $3.24 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.95 Typical High $3.80 | Professional | None | $1.29 | $1.95 | $3.80 |
Well Sense Setting Facility Modifier None Typical Low $3.24 Median $4.37 Typical High $6.46 | Facility | None | $3.24 | $4.37 | $6.46 |
Well Sense Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
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 $0.85 Median $0.85 Typical High $3.89 | Professional | 52 · Reduced service | $0.85 | $0.85 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.34 Typical High $1.55 | Professional | 53 · Discontinued | $0.34 | $0.34 | $1.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.26 Typical High $1.15 | Professional | 55 · Aftercare only | $0.26 | $0.26 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.78 |
Where Massachusetts sits
The same service costs 2.2 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· 22nd of 51
$2.75
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.