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 $11.22 Median $11.22 Typical High $13.49 | Facility | None | $11.22 | $11.22 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.48 | Professional | None | $11.22 | $11.22 | $11.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $11.48 Median $27.54 Typical High $36.31 | Facility | None | $11.48 | $27.54 | $36.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $10.72 Median $11.22 Typical High $16.22 | Professional | None | $10.72 | $11.22 | $16.22 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $11.22 Median $12.59 Typical High $22.91 | Facility | None | $11.22 | $12.59 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $23.44 Typical High $47.86 | Facility | None | $14.45 | $23.44 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $14.13 | Professional | None | $11.22 | $11.22 | $14.13 |
Fallon Health Setting Facility Modifier None Typical Low $11.22 Median $15.14 Typical High $21.38 | Facility | None | $11.22 | $15.14 | $21.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $18.20 | Professional | None | $10.72 | $10.72 | $18.20 |
Mass General Brigham Setting Facility Modifier None Typical Low $11.48 Median $27.54 Typical High $36.31 | Facility | None | $11.48 | $27.54 | $36.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $10.72 Median $11.22 Typical High $16.22 | Professional | None | $10.72 | $11.22 | $16.22 |
United Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
United Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $18.20 | Professional | None | $10.72 | $10.72 | $18.20 |
Well Sense Setting Facility Modifier None Typical Low $11.75 Median $15.49 Typical High $25.70 | Facility | None | $11.75 | $15.49 | $25.70 |
Well Sense Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $13.18 | Professional | None | $11.22 | $11.22 | $13.18 |
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 $1.66 Median $1.66 Typical High $1.74 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.15 |
Where Massachusetts sits
The same service costs 1.9 times more in Alaska 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· 21st of 51
$11.48
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.