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 $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
AllWays Health Partners Setting Facility Modifier None Typical Low $5.62 Median $7.41 Typical High $16.60 | Facility | None | $5.62 | $7.41 | $16.60 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.29 Median $2.45 Typical High $14.13 | Professional | None | $2.29 | $2.45 | $14.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $2.29 Median $2.57 Typical High $4.68 | Facility | None | $2.29 | $2.57 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $4.79 Typical High $9.77 | Facility | None | $2.95 | $4.79 | $9.77 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $3.80 | Professional | None | $2.29 | $2.29 | $3.80 |
Fallon Health Setting Facility Modifier None Typical Low $2.29 Median $2.95 Typical High $3.55 | Facility | None | $2.29 | $2.95 | $3.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.29 Median $2.45 Typical High $7.08 | Professional | None | $2.29 | $2.45 | $7.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $5.62 Median $7.41 Typical High $16.60 | Facility | None | $5.62 | $7.41 | $16.60 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.29 Median $2.45 Typical High $14.13 | Professional | None | $2.29 | $2.45 | $14.13 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $14.13 | Professional | None | $2.45 | $2.45 | $14.13 |
Well Sense Setting Facility Modifier None Typical Low $2.75 Median $3.47 Typical High $5.25 | Facility | None | $2.75 | $3.47 | $5.25 |
Well Sense Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
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 $1.12 Median $1.12 Typical High $1.12 | Professional | 52 · Reduced service | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.45 Typical High $0.47 | Professional | 53 · Discontinued | $0.45 | $0.45 | $0.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.34 Typical High $0.35 | Professional | 55 · Aftercare only | $0.34 | $0.34 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.24 |
Where Massachusetts sits
The same service costs 4.8 times more in Oklahoma than in Georgia. 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· 45th of 51
$2.45
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.