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 $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $3.24 | Facility | None | $1.00 | $1.00 | $3.24 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.00 Median $9.55 Typical High $14.13 | Professional | None | $1.00 | $9.55 | $14.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $8.13 Median $9.12 Typical High $16.60 | Facility | None | $8.13 | $9.12 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $83.18 | Facility | None | $56.23 | $83.18 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $8.13 Median $9.55 Typical High $16.22 | Professional | None | $8.13 | $9.55 | $16.22 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $3.24 | Facility | None | $1.00 | $1.00 | $3.24 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.00 Median $9.55 Typical High $14.13 | Professional | None | $1.00 | $9.55 | $14.13 |
United Setting Professional Modifier None Typical Low $8.13 Median $9.55 Typical High $16.22 | Professional | None | $8.13 | $9.55 | $16.22 |
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 $4.07 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.81 |
Where Massachusetts sits
The same service costs 13.8 times more in Alaska than in New York. 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· 28th of 51
$9.12
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.