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 $3.55 Median $3.55 Typical High $4.47 | Facility | None | $3.55 | $3.55 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | None | $3.55 | $3.55 | $3.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $7.59 Median $8.91 Typical High $11.48 | Facility | None | $7.59 | $8.91 | $11.48 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $10.23 | Professional | None | $3.39 | $3.55 | $10.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $3.55 Median $4.07 Typical High $7.41 | Facility | None | $3.55 | $4.07 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $4.57 Median $7.41 Typical High $15.49 | Facility | None | $4.57 | $7.41 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $6.76 | Professional | None | $3.55 | $3.55 | $6.76 |
Fallon Health Setting Facility Modifier None Typical Low $3.55 Median $4.68 Typical High $5.50 | Facility | None | $3.55 | $4.68 | $5.50 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $12.02 | Professional | None | $3.39 | $3.55 | $12.02 |
Health New England Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $7.59 Median $8.91 Typical High $11.48 | Facility | None | $7.59 | $8.91 | $11.48 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $10.23 | Professional | None | $3.39 | $3.55 | $10.23 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $10.23 | Professional | None | $3.39 | $3.39 | $10.23 |
Well Sense Setting Facility Modifier None Typical Low $3.72 Median $5.01 Typical High $8.32 | Facility | None | $3.72 | $5.01 | $8.32 |
Well Sense Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.27 | Professional | None | $3.55 | $3.55 | $4.27 |
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 $1.78 Median $1.78 Typical High $1.86 | Professional | 52 · Reduced service | $1.78 | $1.78 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.74 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.56 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.37 |
Where Massachusetts sits
The same service costs 4.0 times more in Oklahoma than in Maryland. 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· 26th of 51
$3.72
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.