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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4.17 Median $12.88 Typical High $18.20 | Facility | None | $4.17 | $12.88 | $18.20 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.29 Median $4.17 Typical High $79.43 | Professional | None | $2.29 | $4.17 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $31.62 Typical High $66.07 | Facility | None | $19.50 | $31.62 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
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 $1.74 Median $2.57 Typical High $4.47 | Professional | None | $1.74 | $2.57 | $4.47 |
Mass General Brigham Setting Facility Modifier None Typical Low $4.17 Median $12.88 Typical High $18.20 | Facility | None | $4.17 | $12.88 | $18.20 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.29 Median $4.17 Typical High $79.43 | Professional | None | $2.29 | $4.17 | $79.43 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.57 Typical High $4.47 | Professional | None | $1.74 | $2.57 | $4.47 |
Well Sense Setting Facility Modifier None Typical Low $11.48 Median $19.95 Typical High $35.48 | Facility | None | $11.48 | $19.95 | $35.48 |
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 $7.59 Median $7.59 Typical High $7.59 | Professional | 52 · Reduced service | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $1.51 |
Where Massachusetts sits
The same service costs 4.8 times more in Maryland than in Kentucky. 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· 46th of 51
$4.47
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.