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 $0.89 Median $0.89 Typical High $9.77 | Facility | None | $0.89 | $0.89 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.93 | Professional | None | $0.89 | $0.89 | $0.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.15 Median $2.24 Typical High $2.95 | Facility | None | $1.15 | $2.24 | $2.95 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.89 Median $1.02 Typical High $2.57 | Professional | None | $0.89 | $1.02 | $2.57 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.89 Median $1.02 Typical High $1.86 | Facility | None | $0.89 | $1.02 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $1.15 Median $1.91 Typical High $3.89 | Facility | None | $1.15 | $1.91 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.95 | Professional | None | $0.89 | $0.89 | $0.95 |
Fallon Health Setting Facility Modifier None Typical Low $0.89 Median $1.17 Typical High $1.41 | Facility | None | $0.89 | $1.17 | $1.41 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.89 Median $1.02 Typical High $2.57 | Professional | None | $0.89 | $1.02 | $2.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.15 Median $2.24 Typical High $2.95 | Facility | None | $1.15 | $2.24 | $2.95 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.89 Median $1.02 Typical High $2.57 | Professional | None | $0.89 | $1.02 | $2.57 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $2.57 | Professional | None | $1.02 | $1.02 | $2.57 |
Well Sense Setting Facility Modifier None Typical Low $1.02 Median $1.35 Typical High $2.09 | Facility | None | $1.02 | $1.35 | $2.09 |
Well Sense Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.07 | Professional | None | $0.89 | $0.89 | $1.07 |
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 $0.14 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Where Massachusetts sits
The same service costs 2.3 times more in South Carolina than in North Dakota. 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· 21st of 51
$1.02
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.