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 $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.72 | Professional | None | $3.24 | $3.24 | $3.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $8.13 Median $10.72 Typical High $23.44 | Facility | None | $8.13 | $10.72 | $23.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.16 Median $3.24 Typical High $4.79 | Professional | None | $3.16 | $3.24 | $4.79 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $3.24 Median $3.72 Typical High $6.76 | Facility | None | $3.24 | $3.72 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $6.76 Typical High $14.13 | Facility | None | $4.17 | $6.76 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.80 | Professional | None | $3.24 | $3.24 | $3.80 |
Fallon Health Setting Facility Modifier None Typical Low $3.24 Median $4.27 Typical High $5.01 | Facility | None | $3.24 | $4.27 | $5.01 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.16 Median $3.24 Typical High $5.37 | Professional | None | $3.16 | $3.24 | $5.37 |
Mass General Brigham Setting Facility Modifier None Typical Low $8.13 Median $10.72 Typical High $23.44 | Facility | None | $8.13 | $10.72 | $23.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.16 Median $3.24 Typical High $4.79 | Professional | None | $3.16 | $3.24 | $4.79 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $5.37 | Professional | None | $3.16 | $3.16 | $5.37 |
Well Sense Setting Facility Modifier None Typical Low $3.47 Median $4.79 Typical High $7.59 | Facility | None | $3.47 | $4.79 | $7.59 |
Well Sense Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.89 | Professional | None | $3.24 | $3.24 | $3.89 |
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 $1.62 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.33 |
Where Massachusetts sits
The same service costs 2.0 times more in Arizona than in Oklahoma. 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· 13th of 51
$3.47
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.