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 $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.38 | Professional | None | $18.62 | $18.62 | $21.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $16.60 Median $20.42 Typical High $60.26 | Facility | None | $16.60 | $20.42 | $60.26 |
AllWays Health Partners Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $27.54 | Professional | None | $18.20 | $18.62 | $27.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $18.62 Median $20.89 Typical High $38.02 | Facility | None | $18.62 | $20.89 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $38.90 Typical High $81.28 | Facility | None | $23.99 | $38.90 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.38 | Professional | None | $18.62 | $18.62 | $21.38 |
Fallon Health Setting Facility Modifier None Typical Low $18.62 Median $25.12 Typical High $36.31 | Facility | None | $18.62 | $25.12 | $36.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $30.90 | Professional | None | $18.20 | $18.62 | $30.90 |
Mass General Brigham Setting Facility Modifier None Typical Low $16.60 Median $20.42 Typical High $60.26 | Facility | None | $16.60 | $20.42 | $60.26 |
Mass General Brigham Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $27.54 | Professional | None | $18.20 | $18.62 | $27.54 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $30.90 | Professional | None | $18.20 | $18.20 | $30.90 |
Well Sense Setting Facility Modifier None Typical Low $19.95 Median $26.92 Typical High $42.66 | Facility | None | $19.95 | $26.92 | $42.66 |
Well Sense Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $22.39 | Professional | None | $18.62 | $18.62 | $22.39 |
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 $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Where Massachusetts sits
The same service costs 1.5 times more in Alaska than in Rhode Island. 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· 25th of 51
$18.62
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.