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 $2.29 Median $2.29 Typical High $10.47 | Facility | None | $2.29 | $2.29 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $10.47 | Professional | None | $2.29 | $2.29 | $10.47 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4.79 Median $5.01 Typical High $16.98 | Facility | None | $4.79 | $5.01 | $16.98 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.04 Median $5.37 Typical High $26.92 | Professional | None | $2.04 | $5.37 | $26.92 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $3.31 Median $3.72 Typical High $3.72 | Professional | None | $3.31 | $3.72 | $3.72 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Facility | None | $3.55 | $3.55 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.17 | Professional | None | $2.95 | $2.95 | $4.17 |
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 $2.00 Median $4.57 Typical High $4.79 | Professional | None | $2.00 | $4.57 | $4.79 |
Health New England Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $4.79 Median $5.01 Typical High $16.98 | Facility | None | $4.79 | $5.01 | $16.98 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.04 Median $5.37 Typical High $26.92 | Professional | None | $2.04 | $5.37 | $26.92 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.63 Typical High $5.13 | Professional | None | $1.74 | $2.63 | $5.13 |
Well Sense Setting Facility Modifier None Typical Low $4.37 Median $5.89 Typical High $8.71 | Facility | None | $4.37 | $5.89 | $8.71 |
Well Sense Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.07 | Professional | None | $3.39 | $3.39 | $4.07 |
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 $1.15 Median $1.15 Typical High $5.25 | Professional | 52 · Reduced service | $1.15 | $1.15 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.46 Typical High $2.09 | Professional | 53 · Discontinued | $0.46 | $0.46 | $2.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.34 Typical High $1.58 | Professional | 55 · Aftercare only | $0.34 | $0.34 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $1.05 |
Where Massachusetts sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 23rd of 51
$3.72
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.