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 $4.27 Median $4.27 Typical High $22.39 | Facility | None | $4.27 | $4.27 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | None | $4.27 | $4.27 | $5.01 |
AllWays Health Partners Setting Facility Modifier None Typical Low $10.72 Median $11.48 Typical High $34.67 | Facility | None | $10.72 | $11.48 | $34.67 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4.37 Median $9.77 Typical High $15.85 | Professional | None | $4.37 | $9.77 | $15.85 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $17.78 Median $20.42 Typical High $36.31 | Facility | None | $17.78 | $20.42 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $37.15 Typical High $37.15 | Facility | None | $34.67 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $7.08 | Professional | None | $5.13 | $5.13 | $7.08 |
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 $5.62 Median $10.00 Typical High $21.38 | Professional | None | $5.62 | $10.00 | $21.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $10.72 Median $11.48 Typical High $34.67 | Facility | None | $10.72 | $11.48 | $34.67 |
Mass General Brigham Setting Professional Modifier None Typical Low $4.37 Median $9.77 Typical High $15.85 | Professional | None | $4.37 | $9.77 | $15.85 |
United Setting Professional Modifier None Typical Low $3.72 Median $7.59 Typical High $23.99 | Professional | None | $3.72 | $7.59 | $23.99 |
Well Sense Setting Facility Modifier None Typical Low $9.33 Median $12.59 Typical High $18.20 | Facility | None | $9.33 | $12.59 | $18.20 |
Well Sense Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.51 | Professional | None | $7.08 | $7.08 | $8.51 |
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 $0.65 Median $0.65 Typical High $0.76 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.50 |
Where Massachusetts sits
The same service costs 4.7 times more in Florida than in New York. 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· 8th of 51
$11.48
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.