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 $28.18 Median $28.18 Typical High $93.33 | Facility | None | $28.18 | $28.18 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | None | $28.18 | $28.18 | $29.51 |
AllWays Health Partners Setting Facility Modifier None Typical Low $24.55 Median $83.18 Typical High $104.71 | Facility | None | $24.55 | $83.18 | $104.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $39.81 | Professional | None | $24.55 | $28.18 | $39.81 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $28.18 Median $32.36 Typical High $57.54 | Facility | None | $28.18 | $32.36 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $58.88 Typical High $123.03 | Facility | None | $36.31 | $58.88 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | None | $28.18 | $28.18 | $29.51 |
Fallon Health Setting Facility Modifier None Typical Low $28.18 Median $38.90 Typical High $56.23 | Facility | None | $28.18 | $38.90 | $56.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $46.77 | Professional | None | $24.55 | $28.18 | $46.77 |
Health New England Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $24.55 Median $83.18 Typical High $104.71 | Facility | None | $24.55 | $83.18 | $104.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $39.81 | Professional | None | $24.55 | $28.18 | $39.81 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $41.69 | Professional | None | $24.55 | $24.55 | $41.69 |
Well Sense Setting Facility Modifier None Typical Low $26.92 Median $38.90 Typical High $66.07 | Facility | None | $26.92 | $38.90 | $66.07 |
Well Sense Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | None | $28.18 | $28.18 | $33.88 |
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 $14.13 Median $14.13 Typical High $14.79 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.95 |
Where Massachusetts sits
The same service costs 2.2 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· 36th of 51
$28.18
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.