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 $4.47 Median $4.47 Typical High $23.44 | Facility | None | $4.47 | $4.47 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.25 | Professional | None | $4.47 | $4.47 | $5.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $10.96 Median $11.75 Typical High $36.31 | Facility | None | $10.96 | $11.75 | $36.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4.57 Median $10.23 Typical High $16.60 | Professional | None | $4.57 | $10.23 | $16.60 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $18.62 Median $21.38 Typical High $38.90 | Facility | None | $18.62 | $21.38 | $38.90 |
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 $5.75 Median $10.47 Typical High $22.39 | Professional | None | $5.75 | $10.47 | $22.39 |
Mass General Brigham Setting Facility Modifier None Typical Low $10.96 Median $11.75 Typical High $36.31 | Facility | None | $10.96 | $11.75 | $36.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $4.57 Median $10.23 Typical High $16.60 | Professional | None | $4.57 | $10.23 | $16.60 |
United Setting Professional Modifier None Typical Low $3.89 Median $7.94 Typical High $25.12 | Professional | None | $3.89 | $7.94 | $25.12 |
Well Sense Setting Facility Modifier None Typical Low $9.55 Median $12.88 Typical High $19.05 | Facility | None | $9.55 | $12.88 | $19.05 |
Well Sense Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $8.91 | Professional | None | $7.41 | $7.41 | $8.91 |
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 $0.66 Median $0.66 Typical High $0.78 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $0.52 |
Where Massachusetts sits
The same service costs 4.6 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· 6th of 51
$11.75
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.