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 $2.19 Median $2.19 Typical High $10.00 | Facility | None | $2.19 | $2.19 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $10.00 | Professional | None | $2.19 | $2.19 | $10.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4.57 Median $4.79 Typical High $16.22 | Facility | None | $4.57 | $4.79 | $16.22 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.95 Median $5.13 Typical High $25.70 | Professional | None | $1.95 | $5.13 | $25.70 |
BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.55 Typical High $3.55 | Professional | None | $3.16 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.24 | Facility | None | $3.02 | $3.02 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.55 | Professional | None | $2.57 | $2.57 | $3.55 |
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 $1.91 Median $4.37 Typical High $4.57 | Professional | None | $1.91 | $4.37 | $4.57 |
Health New England Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $4.57 Median $4.79 Typical High $16.22 | Facility | None | $4.57 | $4.79 | $16.22 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.95 Median $5.13 Typical High $25.70 | Professional | None | $1.95 | $5.13 | $25.70 |
Tufts Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.17 | Professional | None | $3.24 | $3.24 | $4.17 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.51 Typical High $4.90 | Professional | None | $1.66 | $2.51 | $4.90 |
Well Sense Setting Facility Modifier None Typical Low $4.17 Median $5.50 Typical High $8.32 | Facility | None | $4.17 | $5.50 | $8.32 |
Well Sense Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.80 | Professional | None | $3.24 | $3.24 | $3.80 |
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 $1.10 Median $1.10 Typical High $5.01 | Professional | 52 · Reduced service | $1.10 | $1.10 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $2.00 | Professional | 53 · Discontinued | $0.44 | $0.44 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $1.51 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $1.00 |
Where Massachusetts sits
The same service costs 2.3 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· 21st of 51
$3.55
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.