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 $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
AllWays Health Partners Setting Facility Modifier None Typical Low $5.50 Median $15.49 Typical High $18.20 | Facility | None | $5.50 | $15.49 | $18.20 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.72 Median $4.57 Typical High $6.03 | Professional | None | $3.72 | $4.57 | $6.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $3.72 Median $4.27 Typical High $7.76 | Facility | None | $3.72 | $4.27 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $7.94 Typical High $16.22 | Facility | None | $4.79 | $7.94 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.68 | Professional | None | $3.72 | $3.72 | $4.68 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $6.31 | Professional | None | $3.72 | $3.72 | $6.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $5.50 Median $15.49 Typical High $18.20 | Facility | None | $5.50 | $15.49 | $18.20 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.72 Median $4.57 Typical High $6.03 | Professional | None | $3.72 | $4.57 | $6.03 |
United Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $6.31 | Professional | None | $3.72 | $3.72 | $6.31 |
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 $1.82 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 53 · Discontinued | $0.72 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Where Massachusetts sits
The same service costs 2.2 times more in Kansas than in Hawaii. 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· 24th of 51
$3.72
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.