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 $1.51 Median $1.51 Typical High $1.78 | Facility | None | $1.51 | $1.51 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.10 Median $5.25 Typical High $14.45 | Facility | None | $1.10 | $5.25 | $14.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.66 Median $1.78 Typical High $3.02 | Professional | None | $1.66 | $1.78 | $3.02 |
BCBS Setting Facility Modifier None Typical Low $1.78 Median $2.04 Typical High $3.63 | Facility | None | $1.78 | $2.04 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $3.72 Typical High $7.76 | Facility | None | $2.29 | $3.72 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $1.35 Median $1.78 Typical High $1.78 | Professional | None | $1.35 | $1.78 | $1.78 |
Fallon Health Setting Facility Modifier None Typical Low $1.78 Median $2.45 Typical High $5,888.44 | Facility | None | $1.78 | $2.45 | $5,888.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.66 Median $1.78 Typical High $3.02 | Professional | None | $1.66 | $1.78 | $3.02 |
Health New England Setting Facility Modifier None Typical Low $10.72 Median $15.14 Typical High $40.74 | Facility | None | $10.72 | $15.14 | $40.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.10 Median $5.25 Typical High $14.45 | Facility | None | $1.10 | $5.25 | $14.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.66 Median $1.78 Typical High $3.02 | Professional | None | $1.66 | $1.78 | $3.02 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $3.02 | Professional | None | $1.66 | $1.66 | $3.02 |
Well Sense Setting Facility Modifier None Typical Low $1.82 Median $2.34 Typical High $4.07 | Facility | None | $1.82 | $2.34 | $4.07 |
Well Sense Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $2.14 | Professional | None | $1.78 | $1.78 | $2.14 |
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 $0.89 Median $0.89 Typical High $0.89 | Professional | 52 · Reduced service | $0.89 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 53 · Discontinued | $0.35 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.18 |
Where Massachusetts sits
The same service costs 2.6 times more in Texas 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· 30th of 51
$1.78
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.