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 $1.70 Median $1.70 Typical High $38.02 | Facility | None | $1.70 | $1.70 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4.17 Median $38.02 Typical High $125.89 | Facility | None | $4.17 | $38.02 | $125.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $56.23 | Professional | None | $37.15 | $38.02 | $56.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $42.66 Median $48.98 Typical High $89.13 | Facility | None | $42.66 | $48.98 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $165.96 | Facility | None | $48.98 | $79.43 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $47.86 | Professional | None | $38.02 | $38.02 | $47.86 |
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 $1.29 Median $4.17 Typical High $45.71 | Professional | None | $1.29 | $4.17 | $45.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $4.17 Median $38.02 Typical High $125.89 | Facility | None | $4.17 | $38.02 | $125.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $56.23 | Professional | None | $37.15 | $38.02 | $56.23 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $63.10 | Professional | None | $37.15 | $37.15 | $63.10 |
Well Sense Setting Facility Modifier None Typical Low $38.02 Median $52.48 Typical High $79.43 | Facility | None | $38.02 | $52.48 | $79.43 |
Well Sense Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | None | $38.02 | $38.02 | $45.71 |
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 $19.05 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Where Massachusetts sits
The same service costs 20.4 times more in Arizona 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· 19th of 51
$38.02
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.