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 $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $8.32 | Professional | None | $5.89 | $5.89 | $8.32 |
AllWays Health Partners Setting Facility Modifier None Typical Low $12.30 Median $12.88 Typical High $42.66 | Facility | None | $12.30 | $12.88 | $42.66 |
AllWays Health Partners Setting Professional Modifier None Typical Low $5.25 Median $13.80 Typical High $67.61 | Professional | None | $5.25 | $13.80 | $67.61 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $31.62 | Facility | None | $10.23 | $10.23 | $31.62 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $9.12 Median $9.55 Typical High $9.55 | Professional | None | $9.12 | $9.55 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $9.55 | Professional | None | $6.92 | $6.92 | $9.55 |
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 $5.13 Median $11.75 Typical High $12.30 | Professional | None | $5.13 | $11.75 | $12.30 |
Health New England Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Health New England Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Mass General Brigham Setting Facility Modifier None Typical Low $12.30 Median $12.88 Typical High $42.66 | Facility | None | $12.30 | $12.88 | $42.66 |
Mass General Brigham Setting Professional Modifier None Typical Low $5.25 Median $13.80 Typical High $67.61 | Professional | None | $5.25 | $13.80 | $67.61 |
Tufts Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $11.22 | Professional | None | $8.71 | $8.71 | $11.22 |
United Setting Professional Modifier None Typical Low $4.47 Median $6.76 Typical High $13.18 | Professional | None | $4.47 | $6.76 | $13.18 |
Well Sense Setting Facility Modifier None Typical Low $11.22 Median $14.79 Typical High $21.88 | Facility | None | $11.22 | $14.79 | $21.88 |
Well Sense Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.47 | Professional | None | $8.71 | $8.71 | $10.47 |
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 $2.95 Median $2.95 Typical High $4.07 | Professional | 52 · Reduced service | $2.95 | $2.95 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.17 Typical High $1.66 | Professional | 53 · Discontinued | $1.17 | $1.17 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $1.23 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $0.81 |
Where Massachusetts sits
The same service costs 2.2 times more in Hawaii than in Maine. 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· 20th of 51
$9.55
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.