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 $22.39 Median $22.39 Typical High $56.23 | Facility | None | $22.39 | $22.39 | $56.23 |
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 $18.20 Median $23.99 Typical High $85.11 | Facility | None | $18.20 | $23.99 | $85.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $7.24 Median $20.89 Typical High $31.62 | Professional | None | $7.24 | $20.89 | $31.62 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $20.89 Median $23.99 Typical High $43.65 | Facility | None | $20.89 | $23.99 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $43.65 Typical High $91.20 | Facility | None | $26.92 | $43.65 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $26.30 | Professional | None | $20.89 | $20.89 | $26.30 |
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 $20.89 Median $20.89 Typical High $38.02 | Professional | None | $20.89 | $20.89 | $38.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $18.20 Median $23.99 Typical High $85.11 | Facility | None | $18.20 | $23.99 | $85.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $7.24 Median $20.89 Typical High $31.62 | Professional | None | $7.24 | $20.89 | $31.62 |
United Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $35.48 | Professional | None | $20.89 | $20.89 | $35.48 |
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 Kansas than in Connecticut. 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· 17th of 51
$22.39
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.