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 $0.89 Median $0.89 Typical High $1.29 | Facility | None | $0.89 | $0.89 | $1.29 |
Aetna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 52 · Reduced service | $0.45 | $0.45 | $0.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $173.78 | Professional | None | $43.65 | $87.10 | $173.78 |
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 $43.65 Median $87.10 Typical High $173.78 | Professional | None | $43.65 | $87.10 | $173.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $173.78 | Professional | None | $43.65 | $87.10 | $173.78 |
United Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $173.78 | Professional | None | $43.65 | $87.10 | $173.78 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,511.89 | $3,019.95 | $3,019.95 |
3 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 53 · Discontinued Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 53 · Discontinued | $0.18 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Where Massachusetts sits
The same service costs 177.8 times more in Texas than in Georgia. 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· 3rd of 51
$87.10
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.