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 $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.72 Median $10.96 Typical High $14.45 | Facility | None | $3.72 | $10.96 | $14.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $6.31 | Professional | None | $4.27 | $4.37 | $6.31 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $4.37 Median $5.01 Typical High $9.12 | Facility | None | $4.37 | $5.01 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $5.62 Median $9.12 Typical High $19.05 | Facility | None | $5.62 | $9.12 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.90 | Professional | None | $4.37 | $4.37 | $4.90 |
Fallon Health Setting Facility Modifier None Typical Low $4.37 Median $5.75 Typical High $6.61 | Facility | None | $4.37 | $5.75 | $6.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $7.24 | Professional | None | $4.27 | $4.37 | $7.24 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.72 Median $10.96 Typical High $14.45 | Facility | None | $3.72 | $10.96 | $14.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $6.31 | Professional | None | $4.27 | $4.37 | $6.31 |
United Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
United Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $7.24 | Professional | None | $4.27 | $4.27 | $7.24 |
Well Sense Setting Facility Modifier None Typical Low $4.68 Median $6.17 Typical High $10.23 | Facility | None | $4.68 | $6.17 | $10.23 |
Well Sense Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $5.25 | Professional | None | $4.37 | $4.37 | $5.25 |
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 $2.19 Median $2.19 Typical High $2.19 | Professional | 52 · Reduced service | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 53 · Discontinued | $0.87 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $0.44 |
Where Massachusetts sits
The same service costs 2.7 times more in Alaska than in Oklahoma. 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· 23rd of 51
$4.37
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.