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 $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $21.38 Median $22.39 Typical High $28.84 | Facility | None | $21.38 | $22.39 | $28.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $8.91 Median $13.49 Typical High $20.42 | Professional | None | $8.91 | $13.49 | $20.42 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $15.49 Median $17.78 Typical High $32.36 | Facility | None | $15.49 | $17.78 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $28.84 Typical High $60.26 | Facility | None | $17.78 | $28.84 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $17.38 | Professional | None | $13.80 | $13.80 | $17.38 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $83.18 | Facility | None | $56.23 | $83.18 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $13.49 Median $13.80 Typical High $22.91 | Professional | None | $13.49 | $13.80 | $22.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $21.38 Median $22.39 Typical High $28.84 | Facility | None | $21.38 | $22.39 | $28.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $8.91 Median $13.49 Typical High $20.42 | Professional | None | $8.91 | $13.49 | $20.42 |
United Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $22.91 | Professional | None | $13.49 | $13.49 | $22.91 |
Well Sense Setting Facility Modifier None Typical Low $13.80 Median $15.14 Typical High $27.54 | Facility | None | $13.80 | $15.14 | $27.54 |
Well Sense Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $22.39 | Professional | None | $18.62 | $18.62 | $22.39 |
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 $6.92 Median $6.92 Typical High $6.92 | Professional | 52 · Reduced service | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 53 · Discontinued | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $1.38 |
Where Massachusetts sits
The same service costs 9.1 times more in Alabama 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· 34th of 51
$13.80
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.