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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $47.86 | Professional | None | $42.66 | $42.66 | $47.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $58.88 | Facility | None | $51.29 | $53.70 | $58.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $52.48 Median $173.78 Typical High $302.00 | Professional | None | $52.48 | $173.78 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Fallon Health Setting Facility Modifier None Typical Low $66.07 Median $77.62 Typical High $2,951.21 | Facility | None | $66.07 | $77.62 | $2,951.21 |
Fallon Health Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $77.62 | Professional | None | $66.07 | $66.07 | $77.62 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $144.54 | Professional | None | $52.48 | $102.33 | $144.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $58.88 | Facility | None | $51.29 | $53.70 | $58.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $52.48 Median $173.78 Typical High $302.00 | Professional | None | $52.48 | $173.78 | $302.00 |
United Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $173.78 | Professional | None | $45.71 | $63.10 | $173.78 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,630.78 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
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 $21.38 Median $21.38 Typical High $23.99 | Professional | 52 · Reduced service | $21.38 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $9.55 | Professional | 53 · Discontinued | $8.51 | $8.51 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $7.08 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.79 |
Where Massachusetts sits
The same service costs 4.0 times more in Alaska than in Connecticut. 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
$81.28
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.