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 $10.00 Median $10.00 Typical High $67.61 | Facility | None | $10.00 | $10.00 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $58.88 | Professional | None | $10.00 | $10.00 | $58.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $38.02 Median $83.18 Typical High $109.65 | Facility | None | $38.02 | $83.18 | $109.65 |
AllWays Health Partners Setting Professional Modifier None Typical Low $16.22 Median $32.36 Typical High $85.11 | Professional | None | $16.22 | $32.36 | $85.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $52.48 Median $60.26 Typical High $109.65 | Facility | None | $52.48 | $60.26 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $37.15 | Professional | None | $29.51 | $29.51 | $37.15 |
Fallon Health Setting Facility Modifier None Typical Low $38.90 Median $48.98 Typical High $120.23 | Facility | None | $38.90 | $48.98 | $120.23 |
Fallon Health Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $57.54 | Professional | None | $38.90 | $48.98 | $57.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $16.22 Median $41.69 Typical High $95.50 | Professional | None | $16.22 | $41.69 | $95.50 |
Health New England Setting Facility Modifier None Typical Low $19.95 Median $54.95 Typical High $79.43 | Facility | None | $19.95 | $54.95 | $79.43 |
Mass General Brigham Setting Facility Modifier None Typical Low $38.02 Median $83.18 Typical High $109.65 | Facility | None | $38.02 | $83.18 | $109.65 |
Mass General Brigham Setting Professional Modifier None Typical Low $16.22 Median $32.36 Typical High $85.11 | Professional | None | $16.22 | $32.36 | $85.11 |
Tufts Setting Facility Modifier None Typical Low $51.29 Median $77.62 Typical High $131.83 | Facility | None | $51.29 | $77.62 | $131.83 |
United Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $186.21 | Facility | None | $66.07 | $123.03 | $186.21 |
United Setting Professional Modifier None Typical Low $15.85 Median $26.92 Typical High $123.03 | Professional | None | $15.85 | $26.92 | $123.03 |
Well Sense Setting Facility Modifier None Typical Low $19.50 Median $26.92 Typical High $39.81 | Facility | None | $19.50 | $26.92 | $39.81 |
Well Sense Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $23.44 | Professional | None | $19.50 | $19.50 | $23.44 |
4 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 52 · Reduced service Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Massachusetts sits
The same service costs 4.6 times more in Alabama than in Missouri. 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· 3rd of 51
$45.71
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.