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 $0.56 Median $0.56 Typical High $1.12 | Facility | None | $0.56 | $0.56 | $1.12 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.60 | Professional | None | $0.56 | $0.56 | $0.60 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.56 Median $1.66 Typical High $1.91 | Facility | None | $0.56 | $1.66 | $1.91 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.56 Median $0.65 Typical High $0.72 | Professional | None | $0.56 | $0.65 | $0.72 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.56 Median $0.65 Typical High $1.17 | Facility | None | $0.56 | $0.65 | $1.17 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $1.00 | Professional | None | $0.56 | $0.56 | $1.00 |
Cigna Setting Facility Modifier None Typical Low $0.71 Median $1.15 Typical High $2.40 | Facility | None | $0.71 | $1.15 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Fallon Health Setting Facility Modifier None Typical Low $0.56 Median $0.74 Typical High $0.87 | Facility | None | $0.56 | $0.74 | $0.87 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.56 Median $0.65 Typical High $0.69 | Professional | None | $0.56 | $0.65 | $0.69 |
Health New England Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.47 | Facility | None | $4.37 | $4.37 | $4.47 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.56 Median $1.66 Typical High $1.91 | Facility | None | $0.56 | $1.66 | $1.91 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.56 Median $0.65 Typical High $0.72 | Professional | None | $0.56 | $0.65 | $0.72 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.72 | Professional | None | $0.65 | $0.65 | $0.72 |
Well Sense Setting Facility Modifier None Typical Low $0.65 Median $0.83 Typical High $1.29 | Facility | None | $0.65 | $0.83 | $1.29 |
Well Sense Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.78 | Professional | None | $0.56 | $0.56 | $0.78 |
2 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 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Massachusetts sits
The same service costs 1.9 times more in Wyoming 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· 18th of 51
$0.60
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.