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 $12.88 Median $12.88 Typical High $43.65 | Facility | None | $12.88 | $12.88 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $40.74 | Professional | None | $12.88 | $12.88 | $40.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $16.98 Median $36.31 Typical High $45.71 | Facility | None | $16.98 | $36.31 | $45.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $15.14 Median $37.15 Typical High $169.82 | Professional | None | $15.14 | $37.15 | $169.82 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $34.67 Median $40.74 Typical High $53.70 | Facility | None | $34.67 | $40.74 | $53.70 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $38.02 | Professional | None | $18.62 | $18.62 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Fallon Health Setting Facility Modifier None Typical Low $18.20 Median $22.39 Typical High $32.36 | Facility | None | $18.20 | $22.39 | $32.36 |
Fallon Health Setting Professional Modifier None Typical Low $19.95 Median $23.99 Typical High $32.36 | Professional | None | $19.95 | $23.99 | $32.36 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $17.38 Median $35.48 Typical High $50.12 | Professional | None | $17.38 | $35.48 | $50.12 |
Health New England Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $16.98 Median $36.31 Typical High $45.71 | Facility | None | $16.98 | $36.31 | $45.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $15.14 Median $37.15 Typical High $169.82 | Professional | None | $15.14 | $37.15 | $169.82 |
United Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $17.78 | Facility | None | $15.85 | $15.85 | $17.78 |
United Setting Professional Modifier None Typical Low $16.60 Median $22.39 Typical High $58.88 | Professional | None | $16.60 | $22.39 | $58.88 |
Well Sense Setting Facility Modifier None Typical Low $11.75 Median $14.45 Typical High $26.92 | Facility | None | $11.75 | $14.45 | $26.92 |
Well Sense Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $14.79 | Professional | None | $10.96 | $10.96 | $14.79 |
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 $6.46 Median $6.46 Typical High $9.12 | Professional | 52 · Reduced service | $6.46 | $6.46 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $3.63 | Professional | 53 · Discontinued | $2.57 | $2.57 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.69 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.82 |
Where Massachusetts sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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
$26.30
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.