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 $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $6.03 | Professional | None | $3.55 | $3.55 | $6.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $3.98 Median $4.57 Typical High $8.32 | Facility | None | $3.98 | $4.57 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $7.59 Typical High $15.49 | Facility | None | $4.68 | $7.59 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.17 | Professional | None | $3.63 | $3.63 | $4.17 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.55 Median $3.63 Typical High $6.03 | Professional | None | $3.55 | $3.63 | $6.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $6.03 | Professional | None | $3.55 | $3.55 | $6.03 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $6.03 | Professional | None | $3.55 | $3.55 | $6.03 |
Well Sense Setting Facility Modifier None Typical Low $4.27 Median $5.01 Typical High $7.41 | Facility | None | $4.27 | $5.01 | $7.41 |
Well Sense Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.37 | Professional | None | $3.63 | $3.63 | $4.37 |
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 $1.82 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 53 · Discontinued | $0.72 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Where Massachusetts sits
The same service costs 2.0 times more in Alaska than in Oklahoma. 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· 28th of 51
$3.63
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.