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 $8.32 Median $8.32 Typical High $28.18 | Facility | None | $8.32 | $8.32 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $11.48 | Professional | None | $8.32 | $8.32 | $11.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $9.33 Median $10.23 Typical High $25.12 | Facility | None | $9.33 | $10.23 | $25.12 |
AllWays Health Partners Setting Professional Modifier None Typical Low $9.55 Median $23.44 Typical High $51.29 | Professional | None | $9.55 | $23.44 | $51.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $20.89 Median $23.99 Typical High $31.62 | Facility | None | $20.89 | $23.99 | $31.62 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $17.38 | Professional | None | $10.00 | $10.00 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Fallon Health Setting Facility Modifier None Typical Low $10.23 Median $12.59 Typical High $17.78 | Facility | None | $10.23 | $12.59 | $17.78 |
Fallon Health Setting Professional Modifier None Typical Low $11.22 Median $13.18 Typical High $17.78 | Professional | None | $11.22 | $13.18 | $17.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.00 Median $19.95 Typical High $28.18 | Professional | None | $10.00 | $19.95 | $28.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $9.33 Median $10.23 Typical High $25.12 | Facility | None | $9.33 | $10.23 | $25.12 |
Mass General Brigham Setting Professional Modifier None Typical Low $9.55 Median $23.44 Typical High $51.29 | Professional | None | $9.55 | $23.44 | $51.29 |
United Setting Professional Modifier None Typical Low $8.71 Median $12.02 Typical High $33.88 | Professional | None | $8.71 | $12.02 | $33.88 |
Well Sense Setting Facility Modifier None Typical Low $7.24 Median $9.77 Typical High $14.45 | Facility | None | $7.24 | $9.77 | $14.45 |
Well Sense Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $10.00 | Professional | None | $7.41 | $7.41 | $10.00 |
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 $1.26 Median $1.26 Typical High $1.66 | Professional | 55 · Aftercare only | $1.26 | $1.26 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $1.10 |
Where Massachusetts sits
The same service costs 2.6 times more in Alaska than in Florida. 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· 7th of 51
$13.80
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.