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 $18.62 Median $19.95 Typical High $38.02 | Facility | None | $18.62 | $19.95 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.95 Typical High $20.42 | Professional | None | $18.62 | $19.95 | $20.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $12.88 Median $32.36 Typical High $40.74 | Facility | None | $12.88 | $32.36 | $40.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $15.49 Median $33.11 Typical High $107.15 | Professional | None | $15.49 | $33.11 | $107.15 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $31.62 | Facility | None | $13.80 | $13.80 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Fallon Health Setting Facility Modifier None Typical Low $13.80 Median $16.98 Typical High $23.99 | Facility | None | $13.80 | $16.98 | $23.99 |
Fallon Health Setting Professional Modifier None Typical Low $21.38 Median $25.70 Typical High $34.67 | Professional | None | $21.38 | $25.70 | $34.67 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $14.79 Median $30.20 Typical High $48.98 | Professional | None | $14.79 | $30.20 | $48.98 |
Mass General Brigham Setting Facility Modifier None Typical Low $12.88 Median $32.36 Typical High $40.74 | Facility | None | $12.88 | $32.36 | $40.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $15.49 Median $33.11 Typical High $107.15 | Professional | None | $15.49 | $33.11 | $107.15 |
United Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $13.49 | Facility | None | $12.30 | $12.30 | $13.49 |
United Setting Professional Modifier None Typical Low $14.79 Median $22.91 Typical High $60.26 | Professional | None | $14.79 | $22.91 | $60.26 |
Well Sense Setting Facility Modifier None Typical Low $12.88 Median $15.85 Typical High $26.92 | Facility | None | $12.88 | $15.85 | $26.92 |
Well Sense Setting Professional Modifier None Typical Low $9.77 Median $10.96 Typical High $13.18 | Professional | None | $9.77 | $10.96 | $13.18 |
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 $9.33 Median $9.77 Typical High $10.23 | Professional | 52 · Reduced service | $9.33 | $9.77 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.98 Typical High $4.07 | Professional | 53 · Discontinued | $3.80 | $3.98 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.95 Typical High $3.09 | Professional | 55 · Aftercare only | $2.82 | $2.95 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.95 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.86 | $1.95 | $2.04 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska 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· 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.