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 $1.15 Median $1.15 Typical High $5.25 | Facility | None | $1.15 | $1.15 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $3.02 | Professional | None | $1.15 | $1.15 | $3.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2.51 Median $2.63 Typical High $8.32 | Facility | None | $2.51 | $2.63 | $8.32 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.17 Median $2.63 Typical High $13.18 | Professional | None | $1.17 | $2.63 | $13.18 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.86 | Professional | None | $1.62 | $1.62 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.86 | Professional | None | $1.32 | $1.32 | $1.86 |
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 $1.02 Median $2.29 Typical High $2.51 | Professional | None | $1.02 | $2.29 | $2.51 |
Mass General Brigham Setting Facility Modifier None Typical Low $2.51 Median $2.63 Typical High $8.32 | Facility | None | $2.51 | $2.63 | $8.32 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.17 Median $2.63 Typical High $13.18 | Professional | None | $1.17 | $2.63 | $13.18 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.32 Typical High $2.51 | Professional | None | $0.87 | $1.32 | $2.51 |
Well Sense Setting Facility Modifier None Typical Low $2.19 Median $3.02 Typical High $4.47 | Facility | None | $2.19 | $3.02 | $4.47 |
Well Sense Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $2.00 | Professional | None | $1.66 | $1.66 | $2.00 |
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 $0.58 Median $0.58 Typical High $2.63 | Professional | 52 · Reduced service | $0.58 | $0.58 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $1.05 | Professional | 53 · Discontinued | $0.23 | $0.23 | $1.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.79 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.52 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 12th of 51
$2.29
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.