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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $14.45 | Professional | None | $10.96 | $10.96 | $14.45 |
AllWays Health Partners Setting Facility Modifier None Typical Low $10.96 Median $14.13 Typical High $36.31 | Facility | None | $10.96 | $14.13 | $36.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $40.74 | Professional | None | $10.96 | $11.22 | $40.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $10.96 Median $12.59 Typical High $22.91 | Facility | None | $10.96 | $12.59 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $22.91 Typical High $47.86 | Facility | None | $14.13 | $22.91 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $13.80 | Professional | None | $10.96 | $10.96 | $13.80 |
Fallon Health Setting Facility Modifier None Typical Low $10.96 Median $15.14 Typical High $22.39 | Facility | None | $10.96 | $15.14 | $22.39 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $33.88 | Professional | None | $10.96 | $11.22 | $33.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $10.96 Median $14.13 Typical High $36.31 | Facility | None | $10.96 | $14.13 | $36.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $40.74 | Professional | None | $10.96 | $11.22 | $40.74 |
United Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $40.74 | Professional | None | $11.22 | $11.22 | $40.74 |
Well Sense Setting Facility Modifier None Typical Low $12.30 Median $16.22 Typical High $25.70 | Facility | None | $12.30 | $16.22 | $25.70 |
Well Sense Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $13.18 | Professional | None | $10.96 | $10.96 | $13.18 |
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 $5.50 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.10 |
Where Massachusetts sits
The same service costs 3.7 times more in Wyoming than in Georgia. 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· 20th of 51
$12.02
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.