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 $1.29 Median $1.29 Typical High $10.00 | Facility | None | $1.29 | $1.29 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | None | $1.29 | $1.29 | $1.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2.29 Median $3.24 Typical High $4.27 | Facility | None | $2.29 | $3.24 | $4.27 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.26 Median $1.29 Typical High $4.68 | Professional | None | $1.26 | $1.29 | $4.68 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.29 Median $1.48 Typical High $2.69 | Facility | None | $1.29 | $1.48 | $2.69 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $2.75 Typical High $5.62 | Facility | None | $1.70 | $2.75 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.51 | Professional | None | $1.29 | $1.29 | $1.51 |
Fallon Health Setting Facility Modifier None Typical Low $1.29 Median $1.70 Typical High $2.04 | Facility | None | $1.29 | $1.70 | $2.04 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.26 Median $1.29 Typical High $4.27 | Professional | None | $1.26 | $1.29 | $4.27 |
Health New England Setting Facility Modifier None Typical Low $4.90 Median $6.03 Typical High $9.55 | Facility | None | $4.90 | $6.03 | $9.55 |
Mass General Brigham Setting Facility Modifier None Typical Low $2.29 Median $3.24 Typical High $4.27 | Facility | None | $2.29 | $3.24 | $4.27 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.26 Median $1.29 Typical High $4.68 | Professional | None | $1.26 | $1.29 | $4.68 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $4.68 | Professional | None | $1.26 | $1.26 | $4.68 |
Well Sense Setting Facility Modifier None Typical Low $1.41 Median $1.78 Typical High $3.02 | Facility | None | $1.41 | $1.78 | $3.02 |
Well Sense Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.55 | Professional | None | $1.29 | $1.29 | $1.55 |
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 $0.65 Median $0.65 Typical High $0.68 | Professional | 52 · Reduced service | $0.65 | $0.65 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.27 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.14 |
Where Massachusetts sits
The same service costs 2.5 times more in Texas than in Nebraska. 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· 22nd of 51
$1.35
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.