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 $10.23 Median $10.23 Typical High $50.12 | Facility | None | $10.23 | $10.23 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $12.02 Median $30.20 Typical High $39.81 | Facility | None | $12.02 | $30.20 | $39.81 |
AllWays Health Partners Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $19.05 | Professional | None | $10.00 | $12.02 | $19.05 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $11.48 Median $12.88 Typical High $23.44 | Facility | None | $11.48 | $12.88 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $21.38 Typical High $44.67 | Facility | None | $13.18 | $21.38 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $13.49 | Professional | None | $10.23 | $10.23 | $13.49 |
Fallon Health Setting Facility Modifier None Typical Low $3.89 Median $4.57 Typical High $83.18 | Facility | None | $3.89 | $4.57 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.00 Median $10.23 Typical High $33.88 | Professional | None | $10.00 | $10.23 | $33.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $12.02 Median $30.20 Typical High $39.81 | Facility | None | $12.02 | $30.20 | $39.81 |
Mass General Brigham Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $19.05 | Professional | None | $10.00 | $12.02 | $19.05 |
United Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $19.05 | Professional | None | $10.00 | $10.00 | $19.05 |
Well Sense Setting Facility Modifier None Typical Low $12.02 Median $14.13 Typical High $20.89 | Facility | None | $12.02 | $14.13 | $20.89 |
Well Sense Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $12.30 | Professional | None | $10.23 | $10.23 | $12.30 |
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 $5.13 Median $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | 56 · Pre-op care only | $1.02 | $1.02 | $1.02 |
Where Massachusetts sits
The same service costs 9.1 times more in Alabama than in Virginia. 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· 23rd of 51
$11.48
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.