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 $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.00 Median $2.75 Typical High $3.31 | Facility | None | $1.00 | $2.75 | $3.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.31 Median $0.36 Typical High $1.00 | Professional | None | $0.31 | $0.36 | $1.00 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.65 Median $0.74 Typical High $1.35 | Facility | None | $0.65 | $0.74 | $1.35 |
Cigna Setting Facility Modifier None Typical Low $0.83 Median $1.35 Typical High $2.82 | Facility | None | $0.83 | $1.35 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.81 | Professional | None | $0.65 | $0.65 | $0.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.36 Median $0.65 Typical High $1.07 | Professional | None | $0.36 | $0.65 | $1.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.00 Median $2.75 Typical High $3.31 | Facility | None | $1.00 | $2.75 | $3.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.31 Median $0.36 Typical High $1.00 | Professional | None | $0.31 | $0.36 | $1.00 |
United Setting Professional Modifier None Typical Low $0.31 Median $0.36 Typical High $0.62 | Professional | None | $0.31 | $0.36 | $0.62 |
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 $0.55 Median $0.55 Typical High $0.55 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Massachusetts sits
The same service costs 27.5 times more in Kansas 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· 26th of 51
$0.65
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.