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 $3.63 Median $3.63 Typical High $16.60 | Facility | None | $3.63 | $3.63 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $16.60 | Professional | None | $3.63 | $3.63 | $16.60 |
AllWays Health Partners Setting Facility Modifier None Typical Low $7.76 Median $9.33 Typical High $25.70 | Facility | None | $7.76 | $9.33 | $25.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.24 Median $8.32 Typical High $63.10 | Professional | None | $3.24 | $8.32 | $63.10 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | None | $4.79 | $4.79 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $5.75 Typical High $7.24 | Facility | None | $4.68 | $5.75 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $6.92 | Professional | None | $4.90 | $4.90 | $6.92 |
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 $3.24 Median $7.24 Typical High $7.94 | Professional | None | $3.24 | $7.24 | $7.94 |
Health New England Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Mass General Brigham Setting Facility Modifier None Typical Low $7.76 Median $9.33 Typical High $25.70 | Facility | None | $7.76 | $9.33 | $25.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.24 Median $8.32 Typical High $63.10 | Professional | None | $3.24 | $8.32 | $63.10 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.07 Typical High $7.94 | Professional | None | $2.75 | $4.07 | $7.94 |
Well Sense Setting Facility Modifier None Typical Low $6.76 Median $9.12 Typical High $13.49 | Facility | None | $6.76 | $9.12 | $13.49 |
Well Sense Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.31 | Professional | None | $5.25 | $5.25 | $6.31 |
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 $1.82 Median $1.82 Typical High $8.32 | Professional | 52 · Reduced service | $1.82 | $1.82 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $3.31 | Professional | 53 · Discontinued | $0.72 | $0.72 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $2.45 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $1.66 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $1.66 |
Where Massachusetts sits
The same service costs 2.5 times more in Montana 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· 21st of 51
$6.31
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.