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 $10.72 Median $10.72 Typical High $26.30 | Facility | None | $10.72 | $10.72 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $10.23 Median $25.70 Typical High $33.88 | Facility | None | $10.23 | $25.70 | $33.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $10.23 Median $10.47 Typical High $15.85 | Professional | None | $10.23 | $10.47 | $15.85 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $12.02 Median $13.49 Typical High $24.55 | Facility | None | $12.02 | $13.49 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $22.39 Typical High $46.77 | Facility | None | $13.80 | $22.39 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $13.18 | Professional | None | $10.72 | $10.72 | $13.18 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $83.18 | Facility | None | $56.23 | $83.18 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.23 Median $10.47 Typical High $17.78 | Professional | None | $10.23 | $10.47 | $17.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $10.23 Median $25.70 Typical High $33.88 | Facility | None | $10.23 | $25.70 | $33.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $10.23 Median $10.47 Typical High $15.85 | Professional | None | $10.23 | $10.47 | $15.85 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $17.78 | Professional | None | $10.47 | $10.47 | $17.78 |
Well Sense Setting Facility Modifier None Typical Low $12.59 Median $14.79 Typical High $21.88 | Facility | None | $12.59 | $14.79 | $21.88 |
Well Sense Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $12.88 | Professional | None | $10.72 | $10.72 | $12.88 |
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 $1.62 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $1.07 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona 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· 26th of 51
$10.72
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.