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 $0.85 Median $0.85 Typical High $3.89 | Facility | None | $0.85 | $0.85 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $3.02 | Professional | None | $0.85 | $0.85 | $3.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.86 Median $1.95 Typical High $6.31 | Facility | None | $1.86 | $1.95 | $6.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.87 Median $2.00 Typical High $10.00 | Professional | None | $0.87 | $2.00 | $10.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.41 | Professional | None | $1.23 | $1.23 | $1.41 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.38 | Professional | None | $1.00 | $1.00 | $1.38 |
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 $0.76 Median $1.70 Typical High $1.91 | Professional | None | $0.76 | $1.70 | $1.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.86 Median $1.95 Typical High $6.31 | Facility | None | $1.86 | $1.95 | $6.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.87 Median $2.00 Typical High $10.00 | Professional | None | $0.87 | $2.00 | $10.00 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.98 Typical High $1.91 | Professional | None | $0.65 | $0.98 | $1.91 |
Well Sense Setting Facility Modifier None Typical Low $1.62 Median $2.24 Typical High $3.31 | Facility | None | $1.62 | $2.24 | $3.31 |
Well Sense Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.48 | Professional | None | $1.23 | $1.23 | $1.48 |
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 $0.43 Median $0.43 Typical High $1.95 | Professional | 52 · Reduced service | $0.43 | $0.43 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.78 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.58 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.39 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$1.70
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.