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 $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $14.13 | Facility | None | $4.37 | $4.37 | $14.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.34 Median $5.89 Typical High $7.76 | Professional | None | $2.34 | $5.89 | $7.76 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $4.47 Median $5.13 Typical High $9.33 | Facility | None | $4.47 | $5.13 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Fallon Health Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.57 | Facility | None | $4.37 | $4.37 | $4.57 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.34 Median $5.89 Typical High $8.13 | Professional | None | $2.34 | $5.89 | $8.13 |
Health New England Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $14.13 | Facility | None | $4.37 | $4.37 | $14.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.34 Median $5.89 Typical High $7.76 | Professional | None | $2.34 | $5.89 | $7.76 |
United Setting Professional Modifier None Typical Low $2.34 Median $5.89 Typical High $8.71 | Professional | None | $2.34 | $5.89 | $8.71 |
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 $2.00 Median $2.00 Typical High $2.00 | Professional | 52 · Reduced service | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.60 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.40 | $0.40 | $0.40 |
Where Massachusetts sits
The same service costs 5.9 times more in Hawaii than in Arkansas. 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· 16th of 51
$5.25
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.