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 $6.03 Median $6.03 Typical High $11.75 | Facility | None | $6.03 | $6.03 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $6.17 Median $21.38 Typical High $25.70 | Facility | None | $6.17 | $21.38 | $25.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $6.17 Median $12.30 Typical High $18.20 | Professional | None | $6.17 | $12.30 | $18.20 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $6.17 Median $7.08 Typical High $12.59 | Facility | None | $6.17 | $7.08 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $12.88 Typical High $26.92 | Facility | None | $7.94 | $12.88 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $7.76 | Professional | None | $6.17 | $6.17 | $7.76 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $6.17 Median $10.47 Typical High $18.20 | Professional | None | $6.17 | $10.47 | $18.20 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.17 Median $21.38 Typical High $25.70 | Facility | None | $6.17 | $21.38 | $25.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $6.17 Median $12.30 Typical High $18.20 | Professional | None | $6.17 | $12.30 | $18.20 |
United Setting Professional Modifier None Typical Low $10.47 Median $12.88 Typical High $38.02 | Professional | None | $10.47 | $12.88 | $38.02 |
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 $3.02 Median $3.02 Typical High $3.02 | Professional | 52 · Reduced service | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 53 · Discontinued | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.60 | $0.60 | $0.60 |
Where Massachusetts sits
The same service costs 2.1 times more in Iowa than in Montana. 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· 8th of 51
$10.47
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.