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 $2.95 Median $2.95 Typical High $21.38 | Facility | None | $2.95 | $2.95 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.02 | Professional | None | $2.95 | $2.95 | $3.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.80 Median $7.24 Typical High $9.55 | Facility | None | $3.80 | $7.24 | $9.55 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.95 Median $3.16 Typical High $4.79 | Professional | None | $2.95 | $3.16 | $4.79 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $2.95 Median $3.31 Typical High $6.03 | Facility | None | $2.95 | $3.31 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $6.17 Typical High $12.59 | Facility | None | $3.80 | $6.17 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.79 | Professional | None | $2.95 | $2.95 | $4.79 |
Fallon Health Setting Facility Modifier None Typical Low $2.95 Median $3.80 Typical High $4.57 | Facility | None | $2.95 | $3.80 | $4.57 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.95 Median $3.16 Typical High $9.55 | Professional | None | $2.95 | $3.16 | $9.55 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.80 Median $7.24 Typical High $9.55 | Facility | None | $3.80 | $7.24 | $9.55 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.95 Median $3.16 Typical High $4.79 | Professional | None | $2.95 | $3.16 | $4.79 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $5.37 | Professional | None | $3.16 | $3.16 | $5.37 |
Well Sense Setting Facility Modifier None Typical Low $3.55 Median $4.37 Typical High $6.76 | Facility | None | $3.55 | $4.37 | $6.76 |
Well Sense Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.47 | Professional | None | $2.95 | $2.95 | $3.47 |
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 $0.44 Median $0.44 Typical High $0.45 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.30 |
Where Massachusetts sits
The same service costs 6.0 times more in Oklahoma than in Wyoming. 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· 19th of 51
$3.24
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.