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 $3.09 Median $3.09 Typical High $9.12 | Facility | None | $3.09 | $3.09 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.31 | Professional | None | $3.09 | $3.09 | $3.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $7.59 Median $9.55 Typical High $10.00 | Facility | None | $7.59 | $9.55 | $10.00 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $3.89 | Professional | None | $1.26 | $3.16 | $3.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $3.09 Median $3.47 Typical High $6.31 | Facility | None | $3.09 | $3.47 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $6.46 Typical High $13.18 | Facility | None | $3.98 | $6.46 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.89 | Professional | None | $3.09 | $3.09 | $3.89 |
Fallon Health Setting Facility Modifier None Typical Low $3.09 Median $3.98 Typical High $4.79 | Facility | None | $3.09 | $3.98 | $4.79 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $5.37 | Professional | None | $1.26 | $3.16 | $5.37 |
Mass General Brigham Setting Facility Modifier None Typical Low $7.59 Median $9.55 Typical High $10.00 | Facility | None | $7.59 | $9.55 | $10.00 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $3.89 | Professional | None | $1.26 | $3.16 | $3.89 |
United Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $4.68 | Professional | None | $1.26 | $3.16 | $4.68 |
Well Sense Setting Facility Modifier None Typical Low $3.47 Median $4.47 Typical High $7.08 | Facility | None | $3.47 | $4.47 | $7.08 |
Well Sense Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.63 | Professional | None | $3.09 | $3.09 | $3.63 |
2 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 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.49 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.33 |
Where Massachusetts sits
The same service costs 3.5 times more in Oklahoma than in Virginia. 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· 31st of 51
$3.16
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.