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 $3.02 Median $3.02 Typical High $15.85 | Facility | None | $3.02 | $3.02 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $11.75 | Facility | None | $3.98 | $3.98 | $11.75 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.66 Median $3.98 Typical High $10.00 | Professional | None | $1.66 | $3.98 | $10.00 |
BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $5.37 | Professional | None | $2.51 | $2.51 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $2.24 | Professional | None | $1.62 | $1.62 | $2.24 |
Fallon Health Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $8,511.38 | Facility | None | $60.26 | $100.00 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.40 Median $4.68 Typical High $10.00 | Professional | None | $2.40 | $4.68 | $10.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $11.75 | Facility | None | $3.98 | $3.98 | $11.75 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.66 Median $3.98 Typical High $10.00 | Professional | None | $1.66 | $3.98 | $10.00 |
United Setting Professional Modifier None Typical Low $1.58 Median $5.75 Typical High $10.00 | Professional | None | $1.58 | $5.75 | $10.00 |
Well Sense Setting Facility Modifier None Typical Low $3.16 Median $4.27 Typical High $6.31 | Facility | None | $3.16 | $4.27 | $6.31 |
Well Sense Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $6.03 | Professional | None | $5.01 | $5.01 | $6.03 |
2 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 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.46 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Where Massachusetts sits
The same service costs 5.2 times more in Kansas than in Delaware. 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· 35th of 51
$3.98
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.