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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $66.07 | Facility | None | $51.29 | $51.29 | $66.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $20.42 Median $32.36 Typical High $75.86 | Professional | None | $20.42 | $32.36 | $75.86 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $20.42 Median $22.91 Typical High $41.69 | Facility | None | $20.42 | $22.91 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $38.02 Typical High $89.13 | Facility | None | $26.30 | $38.02 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $45.71 | Professional | None | $20.42 | $20.42 | $45.71 |
Fallon Health Setting Facility Modifier None Typical Low $20.42 Median $32.36 Typical High $52.48 | Facility | None | $20.42 | $32.36 | $52.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $20.42 Median $32.36 Typical High $63.10 | Professional | None | $20.42 | $32.36 | $63.10 |
Mass General Brigham Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $66.07 | Facility | None | $51.29 | $51.29 | $66.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $20.42 Median $32.36 Typical High $75.86 | Professional | None | $20.42 | $32.36 | $75.86 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $75.86 | Professional | None | $32.36 | $32.36 | $75.86 |
Well Sense Setting Facility Modifier None Typical Low $26.30 Median $35.48 Typical High $63.10 | Facility | None | $26.30 | $35.48 | $63.10 |
Well Sense Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | None | $20.42 | $20.42 | $24.55 |
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 $10.23 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.04 |
Where Massachusetts sits
The same service costs 3.8 times more in Oklahoma than in Delaware. 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· 14th of 51
$32.36
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.