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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.24 Median $8.71 Typical High $11.48 | Facility | None | $3.24 | $8.71 | $11.48 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $5.25 | Professional | None | $3.47 | $3.55 | $5.25 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $3.55 Median $3.98 Typical High $7.24 | Facility | None | $3.55 | $3.98 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $4.57 Median $7.41 Typical High $15.14 | Facility | None | $4.57 | $7.41 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.47 | Professional | None | $3.55 | $3.55 | $4.47 |
Fallon Health Setting Facility Modifier None Typical Low $3.55 Median $4.57 Typical High $5.25 | Facility | None | $3.55 | $4.57 | $5.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.89 | Professional | None | $3.55 | $3.55 | $5.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.24 Median $8.71 Typical High $11.48 | Facility | None | $3.24 | $8.71 | $11.48 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $5.25 | Professional | None | $3.47 | $3.55 | $5.25 |
United Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $5.89 | Professional | None | $3.47 | $3.55 | $5.89 |
Well Sense Setting Facility Modifier None Typical Low $3.89 Median $4.90 Typical High $8.13 | Facility | None | $3.89 | $4.90 | $8.13 |
Well Sense Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.27 | Professional | None | $3.55 | $3.55 | $4.27 |
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 $1.78 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.35 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in Illinois. 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· 21st of 51
$3.55
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.