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 $14.45 Median $14.45 Typical High $41.69 | Facility | None | $14.45 | $14.45 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $15.14 | Professional | None | $14.45 | $14.45 | $15.14 |
AllWays Health Partners Setting Facility Modifier None Typical Low $12.88 Median $43.65 Typical High $93.33 | Facility | None | $12.88 | $43.65 | $93.33 |
AllWays Health Partners Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $28.84 | Professional | None | $14.13 | $14.45 | $28.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $30.20 | Facility | None | $14.45 | $16.60 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $30.20 Typical High $63.10 | Facility | None | $18.62 | $30.20 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $15.14 | Professional | None | $14.45 | $14.45 | $15.14 |
Fallon Health Setting Facility Modifier None Typical Low $14.45 Median $19.95 Typical High $37.15 | Facility | None | $14.45 | $19.95 | $37.15 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $28.84 | Professional | None | $14.13 | $14.45 | $28.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $12.88 Median $43.65 Typical High $93.33 | Facility | None | $12.88 | $43.65 | $93.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $28.84 | Professional | None | $14.13 | $14.45 | $28.84 |
United Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $28.84 | Professional | None | $14.13 | $14.13 | $28.84 |
Well Sense Setting Facility Modifier None Typical Low $15.85 Median $20.42 Typical High $33.88 | Facility | None | $15.85 | $20.42 | $33.88 |
Well Sense Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $17.38 | Professional | None | $14.45 | $14.45 | $17.38 |
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 $7.24 Median $7.24 Typical High $7.59 | Professional | 52 · Reduced service | $7.24 | $7.24 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $3.02 | Professional | 53 · Discontinued | $2.88 | $2.88 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.24 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.51 |
Where Massachusetts sits
The same service costs 2.0 times more in Wyoming 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· 17th of 51
$15.14
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.