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 $7.76 Median $7.76 Typical High $19.95 | Facility | None | $7.76 | $7.76 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $8.91 | Professional | None | $7.76 | $7.76 | $8.91 |
AllWays Health Partners Setting Facility Modifier None Typical Low $5.25 Median $20.42 Typical High $24.55 | Facility | None | $5.25 | $20.42 | $24.55 |
AllWays Health Partners Setting Professional Modifier None Typical Low $7.76 Median $8.13 Typical High $12.30 | Professional | None | $7.76 | $8.13 | $12.30 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $7.76 Median $8.91 Typical High $16.22 | Facility | None | $7.76 | $8.91 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $16.22 Typical High $33.88 | Facility | None | $10.00 | $16.22 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $10.96 | Professional | None | $7.76 | $7.76 | $10.96 |
Fallon Health Setting Facility Modifier None Typical Low $7.76 Median $10.00 Typical High $12.02 | Facility | None | $7.76 | $10.00 | $12.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $7.76 Median $8.13 Typical High $13.80 | Professional | None | $7.76 | $8.13 | $13.80 |
Health New England Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Mass General Brigham Setting Facility Modifier None Typical Low $5.25 Median $20.42 Typical High $24.55 | Facility | None | $5.25 | $20.42 | $24.55 |
Mass General Brigham Setting Professional Modifier None Typical Low $7.76 Median $8.13 Typical High $12.30 | Professional | None | $7.76 | $8.13 | $12.30 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $13.80 | Professional | None | $8.13 | $8.13 | $13.80 |
Well Sense Setting Facility Modifier None Typical Low $9.12 Median $11.48 Typical High $18.20 | Facility | None | $9.12 | $11.48 | $18.20 |
Well Sense Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $9.33 | Professional | None | $7.76 | $7.76 | $9.33 |
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 $3.89 Median $3.89 Typical High $4.07 | Professional | 52 · Reduced service | $3.89 | $3.89 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.55 Typical High $1.62 | Professional | 53 · Discontinued | $1.55 | $1.55 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.17 Typical High $1.20 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $0.81 |
Where Massachusetts sits
The same service costs 2.6 times more in Texas than in Oklahoma. 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· 40th of 51
$8.13
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.