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 $7.94 Median $7.94 Typical High $41.69 | Facility | None | $7.94 | $7.94 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $8.51 | Professional | None | $7.94 | $7.94 | $8.51 |
AllWays Health Partners Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $41.69 | Facility | None | $14.13 | $14.13 | $41.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $5.37 Median $14.13 Typical High $26.30 | Professional | None | $5.37 | $14.13 | $26.30 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $13.80 | Professional | None | $9.12 | $9.12 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $20.42 | Professional | None | $14.45 | $14.45 | $20.42 |
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 $7.59 Median $12.30 Typical High $26.30 | Professional | None | $7.59 | $12.30 | $26.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $41.69 | Facility | None | $14.13 | $14.13 | $41.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $5.37 Median $14.13 Typical High $26.30 | Professional | None | $5.37 | $14.13 | $26.30 |
United Setting Professional Modifier None Typical Low $5.13 Median $15.49 Typical High $29.51 | Professional | None | $5.13 | $15.49 | $29.51 |
Well Sense Setting Facility Modifier None Typical Low $11.22 Median $15.14 Typical High $22.39 | Facility | None | $11.22 | $15.14 | $22.39 |
Well Sense Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $15.85 | Professional | None | $13.18 | $13.18 | $15.85 |
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 $1.20 Median $1.20 Typical High $1.29 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $0.85 |
Where Massachusetts sits
The same service costs 3.5 times more in Florida 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· 25th of 51
$14.13
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.