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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $20.42 | Professional | None | $17.78 | $17.78 | $20.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $18.62 Median $19.50 Typical High $58.88 | Facility | None | $18.62 | $19.50 | $58.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $17.38 Median $17.78 Typical High $26.30 | Professional | None | $17.38 | $17.78 | $26.30 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $17.78 Median $20.42 Typical High $37.15 | Facility | None | $17.78 | $20.42 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $37.15 Typical High $77.62 | Facility | None | $22.91 | $37.15 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $22.39 | Professional | None | $17.78 | $17.78 | $22.39 |
Fallon Health Setting Facility Modifier None Typical Low $17.78 Median $24.55 Typical High $46.77 | Facility | None | $17.78 | $24.55 | $46.77 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $17.38 Median $17.78 Typical High $29.51 | Professional | None | $17.38 | $17.78 | $29.51 |
Mass General Brigham Setting Facility Modifier None Typical Low $18.62 Median $19.50 Typical High $58.88 | Facility | None | $18.62 | $19.50 | $58.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $17.38 Median $17.78 Typical High $26.30 | Professional | None | $17.38 | $17.78 | $26.30 |
United Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $29.51 | Professional | None | $17.38 | $17.38 | $29.51 |
Well Sense Setting Facility Modifier None Typical Low $19.50 Median $26.30 Typical High $41.69 | Facility | None | $19.50 | $26.30 | $41.69 |
Well Sense Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $21.38 | Professional | None | $17.78 | $17.78 | $21.38 |
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 $8.91 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $1.78 |
Where Massachusetts sits
The same service costs 1.5 times more in Alaska than in Rhode Island. 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· 22nd of 51
$18.62
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.