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 $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $14.13 | Professional | None | $12.88 | $12.88 | $14.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $15.49 Median $16.22 Typical High $17.78 | Facility | None | $15.49 | $16.22 | $17.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $15.14 Median $50.12 Typical High $91.20 | Professional | None | $15.14 | $50.12 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Fallon Health Setting Facility Modifier None Typical Low $19.95 Median $23.44 Typical High $2,951.21 | Facility | None | $19.95 | $23.44 | $2,951.21 |
Fallon Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $23.44 | Professional | None | $19.95 | $19.95 | $23.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $15.14 Median $30.90 Typical High $43.65 | Professional | None | $15.14 | $30.90 | $43.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $15.49 Median $16.22 Typical High $17.78 | Facility | None | $15.49 | $16.22 | $17.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $15.14 Median $50.12 Typical High $91.20 | Professional | None | $15.14 | $50.12 | $91.20 |
United Setting Professional Modifier None Typical Low $13.49 Median $18.20 Typical High $50.12 | Professional | None | $13.49 | $18.20 | $50.12 |
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 $6.46 Median $6.46 Typical High $7.08 | Professional | 52 · Reduced service | $6.46 | $6.46 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | 53 · Discontinued | $2.57 | $2.57 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.14 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.45 |
Where Massachusetts sits
The same service costs 4.9 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
$23.44
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.