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 $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.39 Median $9.33 Typical High $11.22 | Facility | None | $3.39 | $9.33 | $11.22 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.02 Median $3.55 Typical High $5.37 | Professional | None | $3.02 | $3.55 | $5.37 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $2.19 Median $2.51 Typical High $4.47 | Facility | None | $2.19 | $2.51 | $4.47 |
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 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.19 Median $3.55 Typical High $5.37 | Professional | None | $2.19 | $3.55 | $5.37 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.39 Median $9.33 Typical High $11.22 | Facility | None | $3.39 | $9.33 | $11.22 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.02 Median $3.55 Typical High $5.37 | Professional | None | $3.02 | $3.55 | $5.37 |
United Setting Professional Modifier None Typical Low $3.02 Median $3.55 Typical High $6.03 | Professional | None | $3.02 | $3.55 | $6.03 |
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 $1.51 Median $1.51 Typical High $1.51 | Professional | 52 · Reduced service | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Where Massachusetts sits
The same service costs 1.6 times more in Idaho than in Ohio. 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· 22nd of 51
$3.39
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.