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 $2.69 Median $2.95 Typical High $5.75 | Facility | None | $2.69 | $2.95 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.39 | Professional | None | $2.95 | $2.95 | $3.39 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.63 Median $3.80 Typical High $11.22 | Professional | None | $3.63 | $3.80 | $11.22 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $2.95 Median $3.31 Typical High $6.03 | Facility | None | $2.95 | $3.31 | $6.03 |
Fallon Health Setting Facility Modifier None Typical Low $2.95 Median $3.80 Typical High $4.57 | Facility | None | $2.95 | $3.80 | $4.57 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.63 Median $3.80 Typical High $11.22 | Professional | None | $3.63 | $3.80 | $11.22 |
Health New England Setting Facility Modifier None Typical Low $4.68 Median $12.59 Typical High $20.89 | Facility | None | $4.68 | $12.59 | $20.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.63 Median $3.80 Typical High $11.22 | Professional | None | $3.63 | $3.80 | $11.22 |
Tufts Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.41 | Facility | None | $1.26 | $1.26 | $1.41 |
United Setting Professional Modifier None Typical Low $3.63 Median $3.80 Typical High $11.22 | Professional | None | $3.63 | $3.80 | $11.22 |
Well Sense Setting Facility Modifier None Typical Low $3.63 Median $4.47 Typical High $8.13 | Facility | None | $3.63 | $4.47 | $8.13 |
Well Sense Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
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 $1.48 Median $1.48 Typical High $1.48 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Where Massachusetts sits
The same service costs 2.8 times more in Wyoming than in Florida. 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· 17th of 51
$3.80
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.