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 $7.76 Median $22.91 Typical High $40.74 | Facility | None | $7.76 | $22.91 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $26.30 | Professional | None | $22.91 | $22.91 | $26.30 |
AllWays Health Partners Setting Facility Modifier None Typical Low $6.31 Median $9.12 Typical High $72.44 | Facility | None | $6.31 | $9.12 | $72.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $33.11 | Professional | None | $21.88 | $22.39 | $33.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $22.91 Median $26.30 Typical High $47.86 | Facility | None | $22.91 | $26.30 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $47.86 Typical High $100.00 | Facility | None | $29.51 | $47.86 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | None | $22.91 | $22.91 | $23.99 |
Fallon Health Setting Facility Modifier None Typical Low $22.91 Median $31.62 Typical High $56.23 | Facility | None | $22.91 | $31.62 | $56.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $22.39 Median $22.91 Typical High $38.90 | Professional | None | $22.39 | $22.91 | $38.90 |
Health New England Setting Facility Modifier None Typical Low $18.62 Median $33.11 Typical High $85.11 | Facility | None | $18.62 | $33.11 | $85.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.31 Median $9.12 Typical High $72.44 | Facility | None | $6.31 | $9.12 | $72.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $33.11 | Professional | None | $21.88 | $22.39 | $33.11 |
Tufts Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $173.78 | Facility | None | $3.89 | $3.89 | $173.78 |
United Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $37.15 | Professional | None | $21.88 | $22.39 | $37.15 |
Well Sense Setting Facility Modifier None Typical Low $24.55 Median $32.36 Typical High $53.70 | Facility | None | $24.55 | $32.36 | $53.70 |
Well Sense Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $27.54 | Professional | None | $22.91 | $22.91 | $27.54 |
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 $11.48 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.29 |
Where Massachusetts sits
The same service costs 2.0 times more in Minnesota than in Hawaii. 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
$22.91
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.