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 $6.92 Median $6.92 Typical High $31.62 | Facility | None | $6.92 | $6.92 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $31.62 | Professional | None | $6.92 | $6.92 | $31.62 |
AllWays Health Partners Setting Facility Modifier None Typical Low $14.45 Median $15.14 Typical High $51.29 | Facility | None | $14.45 | $15.14 | $51.29 |
AllWays Health Partners Setting Professional Modifier None Typical Low $6.17 Median $16.22 Typical High $79.43 | Professional | None | $6.17 | $16.22 | $79.43 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $17.78 Median $20.42 Typical High $27.54 | Facility | None | $17.78 | $20.42 | $27.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | None | $10.00 | $10.23 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $9.55 Typical High $9.55 | Facility | None | $8.13 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $11.22 | Professional | None | $8.13 | $8.13 | $11.22 |
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 $6.03 Median $13.80 Typical High $14.45 | Professional | None | $6.03 | $13.80 | $14.45 |
Health New England Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Health New England Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Mass General Brigham Setting Facility Modifier None Typical Low $14.45 Median $15.14 Typical High $51.29 | Facility | None | $14.45 | $15.14 | $51.29 |
Mass General Brigham Setting Professional Modifier None Typical Low $6.17 Median $16.22 Typical High $79.43 | Professional | None | $6.17 | $16.22 | $79.43 |
United Setting Professional Modifier None Typical Low $5.25 Median $7.94 Typical High $15.49 | Professional | None | $5.25 | $7.94 | $15.49 |
Well Sense Setting Facility Modifier None Typical Low $13.18 Median $17.78 Typical High $25.70 | Facility | None | $13.18 | $17.78 | $25.70 |
Well Sense Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $12.02 | Professional | None | $10.00 | $10.00 | $12.02 |
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 $1.05 Median $1.05 Typical High $4.68 | Professional | 55 · Aftercare only | $1.05 | $1.05 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $0.69 Typical High $3.16 | Professional | 56 · Pre-op care only | $0.69 | $0.69 | $3.16 |
Where Massachusetts sits
The same service costs 2.2 times more in Kansas 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· 20th of 51
$11.48
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.