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 $5.01 Median $5.01 Typical High $22.91 | Facility | None | $5.01 | $5.01 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $22.91 | Professional | None | $5.01 | $5.01 | $22.91 |
AllWays Health Partners Setting Facility Modifier None Typical Low $10.72 Median $10.96 Typical High $37.15 | Facility | None | $10.72 | $10.96 | $37.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4.47 Median $11.75 Typical High $58.88 | Professional | None | $4.47 | $11.75 | $58.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.94 | Facility | None | $7.59 | $7.59 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $8.91 | Professional | None | $6.46 | $6.46 | $8.91 |
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 $4.37 Median $10.00 Typical High $10.47 | Professional | None | $4.37 | $10.00 | $10.47 |
Health New England Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $10.72 Median $10.96 Typical High $37.15 | Facility | None | $10.72 | $10.96 | $37.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $4.47 Median $11.75 Typical High $58.88 | Professional | None | $4.47 | $11.75 | $58.88 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $11.22 | Professional | None | $3.80 | $5.75 | $11.22 |
Well Sense Setting Facility Modifier None Typical Low $9.55 Median $12.59 Typical High $19.05 | Facility | None | $9.55 | $12.59 | $19.05 |
Well Sense Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $8.91 | Professional | None | $7.41 | $7.41 | $8.91 |
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 $2.51 Median $2.51 Typical High $11.48 | Professional | 52 · Reduced service | $2.51 | $2.51 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.00 Typical High $4.57 | Professional | 53 · Discontinued | $1.00 | $1.00 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $3.47 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.50 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.50 | $0.50 | $2.29 |
Where Massachusetts sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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
$8.13
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.