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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $23.99 Median $34.67 Typical High $74.13 | Facility | None | $23.99 | $34.67 | $74.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $7.76 Median $47.86 Typical High $74.13 | Professional | None | $7.76 | $47.86 | $74.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $16.60 Median $30.90 Typical High $47.86 | Facility | None | $16.60 | $30.90 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $20.42 Typical High $41.69 | Facility | None | $12.59 | $20.42 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Fallon Health Setting Facility Modifier None Typical Low $25.12 Median $30.20 Typical High $6,918.31 | Facility | None | $25.12 | $30.20 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $7.76 Median $20.89 Typical High $21.38 | Professional | None | $7.76 | $20.89 | $21.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $23.99 Median $34.67 Typical High $74.13 | Facility | None | $23.99 | $34.67 | $74.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $7.76 Median $47.86 Typical High $74.13 | Professional | None | $7.76 | $47.86 | $74.13 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $5.89 Median $8.71 Typical High $13.49 | Professional | None | $5.89 | $8.71 | $13.49 |
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 $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
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 $10.47 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.09 |
Where Massachusetts sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 2nd of 51
$20.89
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.