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 $1.26 Median $1.26 Typical High $5.75 | Facility | None | $1.26 | $1.26 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $5.75 | Professional | None | $1.26 | $1.26 | $5.75 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2.63 Median $2.75 Typical High $9.33 | Facility | None | $2.63 | $2.75 | $9.33 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.12 Median $2.95 Typical High $14.79 | Professional | None | $1.12 | $2.95 | $14.79 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1.82 Median $1.86 Typical High $1.86 | Professional | None | $1.82 | $1.86 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $2.04 | Professional | None | $1.48 | $1.48 | $2.04 |
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 $1.10 Median $2.51 Typical High $2.82 | Professional | None | $1.10 | $2.51 | $2.82 |
Health New England Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
Mass General Brigham Setting Facility Modifier None Typical Low $2.63 Median $2.75 Typical High $9.33 | Facility | None | $2.63 | $2.75 | $9.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.12 Median $2.95 Typical High $14.79 | Professional | None | $1.12 | $2.95 | $14.79 |
United Setting Professional Modifier None Typical Low $0.95 Median $1.45 Typical High $2.82 | Professional | None | $0.95 | $1.45 | $2.82 |
Well Sense Setting Facility Modifier None Typical Low $2.40 Median $3.24 Typical High $4.68 | Facility | None | $2.40 | $3.24 | $4.68 |
Well Sense Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $2.19 | Professional | None | $1.82 | $1.82 | $2.19 |
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 $0.63 Median $0.63 Typical High $2.88 | Professional | 52 · Reduced service | $0.63 | $0.63 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $1.15 | Professional | 53 · Discontinued | $0.25 | $0.25 | $1.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.87 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.58 |
Where Massachusetts sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 22nd of 51
$2.04
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.