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 $17.38 Median $17.38 Typical High $22.39 | Facility | None | $17.38 | $17.38 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
AllWays Health Partners Setting Facility Modifier None Typical Low $19.95 Median $56.23 Typical High $74.13 | Facility | None | $19.95 | $56.23 | $74.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $22.39 Median $22.91 Typical High $37.15 | Professional | None | $22.39 | $22.91 | $37.15 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $22.39 Median $25.70 Typical High $46.77 | Facility | None | $22.39 | $25.70 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $47.86 Typical High $97.72 | Facility | None | $28.84 | $47.86 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $34.67 | Professional | None | $22.39 | $22.39 | $34.67 |
Fallon Health Setting Facility Modifier None Typical Low $22.39 Median $30.90 Typical High $56.23 | Facility | None | $22.39 | $30.90 | $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 |
Mass General Brigham Setting Facility Modifier None Typical Low $19.95 Median $56.23 Typical High $74.13 | Facility | None | $19.95 | $56.23 | $74.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $22.39 Median $22.91 Typical High $37.15 | Professional | None | $22.39 | $22.91 | $37.15 |
United Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $38.90 | Professional | None | $22.91 | $22.91 | $38.90 |
Well Sense Setting Facility Modifier None Typical Low $25.12 Median $31.62 Typical High $52.48 | Facility | None | $25.12 | $31.62 | $52.48 |
Well Sense Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $26.92 | Professional | None | $22.39 | $22.39 | $26.92 |
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 $11.22 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $2.24 |
Where Massachusetts sits
The same service costs 1.9 times more in Alaska than in Mississippi. 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· 47th 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.