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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2.34 Median $2.45 Typical High $7.94 | Facility | None | $2.34 | $2.45 | $7.94 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.15 Median $2.51 Typical High $12.59 | Professional | None | $1.15 | $2.51 | $12.59 |
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 $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
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 $0.95 Median $2.14 Typical High $2.40 | Professional | None | $0.95 | $2.14 | $2.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $2.34 Median $2.45 Typical High $7.94 | Facility | None | $2.34 | $2.45 | $7.94 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.15 Median $2.51 Typical High $12.59 | Professional | None | $1.15 | $2.51 | $12.59 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.23 Typical High $2.40 | Professional | None | $0.81 | $1.23 | $2.40 |
6 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 $2.40 Median $2.40 Typical High $2.40 | Professional | 52 · Reduced service | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 53 · Discontinued | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $0.48 |
Well Sense Setting Facility Modifier AW · With surgical dressing Typical Low $4.17 Median $4.17 Typical High $4.17 | Facility | AW · With surgical dressing | $4.17 | $4.17 | $4.17 |
Well Sense Setting Professional Modifier AW · With surgical dressing Typical Low $3.47 Median $3.47 Typical High $4.17 | Professional | AW · With surgical dressing | $3.47 | $3.47 | $4.17 |
Where Massachusetts sits
The same service costs 4.6 times more in Rhode Island 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· 14th of 51
$2.14
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.