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 $2.57 Median $2.57 Typical High $13.49 | Facility | None | $2.57 | $2.57 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $6.46 Median $6.92 Typical High $125.89 | Facility | None | $6.46 | $6.92 | $125.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.63 Median $6.03 Typical High $14.45 | Professional | None | $2.63 | $6.03 | $14.45 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.24 Median $0.27 Typical High $0.50 | Facility | None | $0.24 | $0.27 | $0.50 |
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 $5.75 Median $5.75 Typical High $7.94 | Professional | None | $5.75 | $5.75 | $7.94 |
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 $3.39 Median $6.03 Typical High $12.88 | Professional | None | $3.39 | $6.03 | $12.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.46 Median $6.92 Typical High $125.89 | Facility | None | $6.46 | $6.92 | $125.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.63 Median $6.03 Typical High $14.45 | Professional | None | $2.63 | $6.03 | $14.45 |
United Setting Professional Modifier None Typical Low $2.24 Median $4.57 Typical High $14.45 | Professional | None | $2.24 | $4.57 | $14.45 |
Well Sense Setting Facility Modifier None Typical Low $5.62 Median $7.59 Typical High $10.96 | Facility | None | $5.62 | $7.59 | $10.96 |
Well Sense Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.13 | Professional | None | $4.27 | $4.27 | $5.13 |
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 $0.39 Median $0.39 Typical High $0.45 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.30 |
Where Massachusetts sits
The same service costs 83.2 times more in Kansas than in Indiana. 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· 24th of 51
$6.03
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.