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 $1.91 Median $1.95 Typical High $2.24 | Facility | None | $1.91 | $1.95 | $2.24 |
Aetna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.45 | Professional | None | $1.95 | $1.95 | $2.45 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.55 Median $4.79 Typical High $6.31 | Facility | None | $1.55 | $4.79 | $6.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | None | $1.95 | $1.95 | $8.91 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.95 Median $2.19 Typical High $3.98 | Facility | None | $1.95 | $2.19 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $2.45 Median $4.07 Typical High $8.32 | Facility | None | $2.45 | $4.07 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $3.39 | Professional | None | $1.91 | $1.91 | $3.39 |
Fallon Health Setting Facility Modifier None Typical Low $1.95 Median $2.51 Typical High $3.02 | Facility | None | $1.95 | $2.51 | $3.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $6.46 | Professional | None | $1.95 | $1.95 | $6.46 |
Health New England Setting Facility Modifier None Typical Low $3.39 Median $9.12 Typical High $15.14 | Facility | None | $3.39 | $9.12 | $15.14 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.55 Median $4.79 Typical High $6.31 | Facility | None | $1.55 | $4.79 | $6.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | None | $1.95 | $1.95 | $8.91 |
United Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | None | $1.95 | $1.95 | $8.91 |
Well Sense Setting Facility Modifier None Typical Low $2.14 Median $2.69 Typical High $4.47 | Facility | None | $2.14 | $2.69 | $4.47 |
Well Sense Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $2.29 | Professional | None | $1.91 | $1.91 | $2.29 |
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 $0.98 Median $0.98 Typical High $1.00 | Professional | 52 · Reduced service | $0.98 | $0.98 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.39 Typical High $0.40 | Professional | 53 · Discontinued | $0.39 | $0.39 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.20 |
Where Massachusetts sits
The same service costs 2.5 times more in Texas than in Tennessee. 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· 29th of 51
$2.04
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.