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 $0.55 Median $0.55 Typical High $1.82 | Facility | None | $0.55 | $0.55 | $1.82 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.56 | Professional | None | $0.55 | $0.55 | $0.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.63 Median $1.62 Typical High $3.63 | Facility | None | $0.63 | $1.62 | $3.63 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.42 Median $0.55 Typical High $1.10 | Professional | None | $0.42 | $0.55 | $1.10 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.55 Median $0.63 Typical High $1.12 | Facility | None | $0.55 | $0.63 | $1.12 |
Cigna Setting Facility Modifier None Typical Low $0.71 Median $1.15 Typical High $2.40 | Facility | None | $0.71 | $1.15 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Fallon Health Setting Facility Modifier None Typical Low $0.55 Median $0.72 Typical High $0.85 | Facility | None | $0.55 | $0.72 | $0.85 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.42 Median $0.55 Typical High $1.10 | Professional | None | $0.42 | $0.55 | $1.10 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.63 Median $1.62 Typical High $3.63 | Facility | None | $0.63 | $1.62 | $3.63 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.42 Median $0.55 Typical High $1.10 | Professional | None | $0.42 | $0.55 | $1.10 |
United Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $1.10 | Professional | None | $0.42 | $0.42 | $1.10 |
Well Sense Setting Facility Modifier None Typical Low $0.42 Median $0.68 Typical High $1.26 | Facility | None | $0.42 | $0.68 | $1.26 |
Well Sense Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.65 | Professional | None | $0.54 | $0.54 | $0.65 |
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 $0.28 Median $0.28 Typical High $0.28 | Professional | 52 · Reduced service | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Massachusetts sits
The same service costs 2.1 times more in Arizona than in Maryland. 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· 31st of 51
$0.55
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.