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 $4.90 Median $4.90 Typical High $7.08 | Facility | None | $4.90 | $4.90 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.82 Median $8.51 Typical High $28.18 | Professional | None | $2.82 | $8.51 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $7.76 Typical High $16.22 | Facility | None | $4.79 | $7.76 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.47 | Professional | None | $3.72 | $3.72 | $4.47 |
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 $2.95 Median $5.25 Typical High $8.91 | Professional | None | $2.95 | $5.25 | $8.91 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.82 Median $8.51 Typical High $28.18 | Professional | None | $2.82 | $8.51 | $28.18 |
United Setting Professional Modifier None Typical Low $2.24 Median $5.62 Typical High $8.91 | Professional | None | $2.24 | $5.62 | $8.91 |
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 |
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 $2.45 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | 53 · Discontinued | $0.98 | $0.98 | $0.98 |
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 $0.49 Median $0.49 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.49 | $0.49 | $0.49 |
Where Massachusetts sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 9th of 51
$5.25
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.