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 $2.04 Median $2.04 Typical High $9.12 | Facility | None | $2.04 | $2.04 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $9.12 | Professional | None | $2.04 | $2.04 | $9.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2.88 Median $4.17 Typical High $14.45 | Facility | None | $2.88 | $4.17 | $14.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.82 Median $4.68 Typical High $22.91 | Professional | None | $1.82 | $4.68 | $22.91 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $8.91 | Facility | None | $2.95 | $2.95 | $8.91 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | None | $3.24 | $3.31 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.95 | Facility | None | $2.57 | $2.57 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $3.09 | Professional | None | $1.91 | $2.19 | $3.09 |
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 $1.78 Median $4.07 Typical High $4.17 | Professional | None | $1.78 | $4.07 | $4.17 |
Health New England Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Mass General Brigham Setting Facility Modifier None Typical Low $2.88 Median $4.17 Typical High $14.45 | Facility | None | $2.88 | $4.17 | $14.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.82 Median $4.68 Typical High $22.91 | Professional | None | $1.82 | $4.68 | $22.91 |
United Setting Professional Modifier None Typical Low $1.55 Median $2.29 Typical High $4.47 | Professional | None | $1.55 | $2.29 | $4.47 |
Well Sense Setting Facility Modifier None Typical Low $3.80 Median $5.13 Typical High $7.59 | Facility | None | $3.80 | $5.13 | $7.59 |
Well Sense Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
2 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 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $1.38 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.91 |
Where Massachusetts sits
The same service costs 2.5 times more in Hawaii than in Vermont. 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· 16th of 51
$3.24
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.