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 $1.17 Median $1.17 Typical High $1.17 | Facility | None | $1.17 | $1.17 | $1.17 |
Aetna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.20 | Professional | None | $1.17 | $1.17 | $1.20 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Facility | None | $1.05 | $1.05 | $1.05 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $2.29 | Professional | None | $1.15 | $1.15 | $2.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.32 Median $1.48 Typical High $2.69 | Facility | None | $1.32 | $1.48 | $2.69 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $2.45 Typical High $5.13 | Facility | None | $1.51 | $2.45 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.45 | Professional | None | $1.17 | $1.17 | $1.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.15 Median $1.17 Typical High $2.29 | Professional | None | $1.15 | $1.17 | $2.29 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Facility | None | $1.05 | $1.05 | $1.05 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $2.29 | Professional | None | $1.15 | $1.15 | $2.29 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $2.29 | Professional | None | $1.15 | $1.15 | $2.29 |
Well Sense Setting Facility Modifier None Typical Low $1.17 Median $1.62 Typical High $2.40 | Facility | None | $1.17 | $1.62 | $2.40 |
Well Sense Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.41 | Professional | None | $1.17 | $1.17 | $1.41 |
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 $0.59 Median $0.59 Typical High $0.59 | Professional | 52 · Reduced service | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 53 · Discontinued | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.12 |
Where Massachusetts sits
The same service costs 1.7 times more in Alaska than in Hawaii. 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· 21st of 51
$1.17
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.