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 $7.24 Median $7.24 Typical High $33.11 | Facility | None | $7.24 | $7.24 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $33.11 | Professional | None | $7.24 | $7.24 | $33.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $13.80 Median $15.85 Typical High $52.48 | Facility | None | $13.80 | $15.85 | $52.48 |
AllWays Health Partners Setting Professional Modifier None Typical Low $6.46 Median $16.98 Typical High $85.11 | Professional | None | $6.46 | $16.98 | $85.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $32.36 | Facility | None | $10.72 | $10.72 | $32.36 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $10.47 Median $11.75 Typical High $11.75 | Professional | None | $10.47 | $11.75 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $10.00 Typical High $10.00 | Facility | None | $8.91 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $11.75 | Professional | None | $8.51 | $8.51 | $11.75 |
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 $6.31 Median $14.45 Typical High $15.14 | Professional | None | $6.31 | $14.45 | $15.14 |
Health New England Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Mass General Brigham Setting Facility Modifier None Typical Low $13.80 Median $15.85 Typical High $52.48 | Facility | None | $13.80 | $15.85 | $52.48 |
Mass General Brigham Setting Professional Modifier None Typical Low $6.46 Median $16.98 Typical High $85.11 | Professional | None | $6.46 | $16.98 | $85.11 |
United Setting Professional Modifier None Typical Low $5.50 Median $8.32 Typical High $16.22 | Professional | None | $5.50 | $8.32 | $16.22 |
Well Sense Setting Facility Modifier None Typical Low $13.80 Median $18.62 Typical High $27.54 | Facility | None | $13.80 | $18.62 | $27.54 |
Well Sense Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | None | $10.72 | $10.72 | $12.59 |
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 $1.10 Median $1.10 Typical High $5.01 | Professional | 55 · Aftercare only | $1.10 | $1.10 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $3.31 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $3.31 |
Where Massachusetts sits
The same service costs 2.3 times more in Montana than in Connecticut. 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· 19th of 51
$11.75
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.