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 $2.19 Median $2.19 Typical High $12.30 | Facility | None | $2.19 | $2.19 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.02 | Professional | None | $2.19 | $2.19 | $3.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2.29 Median $5.50 Typical High $7.24 | Facility | None | $2.29 | $5.50 | $7.24 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $4.90 | Professional | None | $2.19 | $2.40 | $4.90 |
BCBS Setting Facility Modifier None Typical Low $2.19 Median $2.51 Typical High $4.57 | Facility | None | $2.19 | $2.51 | $4.57 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $4.57 Typical High $9.55 | Facility | None | $2.82 | $4.57 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.69 | Professional | None | $2.19 | $2.19 | $2.69 |
Fallon Health Setting Facility Modifier None Typical Low $2.19 Median $3.09 Typical High $5,888.44 | Facility | None | $2.19 | $3.09 | $5,888.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $4.90 | Professional | None | $2.19 | $2.40 | $4.90 |
Health New England Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $2.29 Median $5.50 Typical High $7.24 | Facility | None | $2.29 | $5.50 | $7.24 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $4.90 | Professional | None | $2.19 | $2.40 | $4.90 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $4.90 | Professional | None | $2.40 | $2.40 | $4.90 |
Well Sense Setting Facility Modifier None Typical Low $2.40 Median $3.31 Typical High $5.13 | Facility | None | $2.40 | $3.31 | $5.13 |
Well Sense Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.63 | Professional | None | $2.19 | $2.19 | $2.63 |
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 $0.33 Median $0.33 Typical High $0.34 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.23 |
Where Massachusetts sits
The same service costs 1.9 times more in Wyoming than in South Carolina. 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· 40th of 51
$2.40
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.