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 $1.00 Median $1.00 Typical High $4.07 | Facility | None | $1.00 | $1.00 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.74 | Professional | None | $1.00 | $1.00 | $1.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.78 Median $2.51 Typical High $3.24 | Facility | None | $1.78 | $2.51 | $3.24 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.89 Median $1.00 Typical High $3.24 | Professional | None | $0.89 | $1.00 | $3.24 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.00 Median $1.12 Typical High $2.04 | Facility | None | $1.00 | $1.12 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $1.29 Median $2.09 Typical High $4.37 | Facility | None | $1.29 | $2.09 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.12 | Professional | None | $1.00 | $1.00 | $1.12 |
Fallon Health Setting Facility Modifier None Typical Low $1.00 Median $1.29 Typical High $1.55 | Facility | None | $1.00 | $1.29 | $1.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.89 Median $1.00 Typical High $3.24 | Professional | None | $0.89 | $1.00 | $3.24 |
Health New England Setting Facility Modifier None Typical Low $3.72 Median $5.89 Typical High $9.77 | Facility | None | $3.72 | $5.89 | $9.77 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.78 Median $2.51 Typical High $3.24 | Facility | None | $1.78 | $2.51 | $3.24 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.89 Median $1.00 Typical High $3.24 | Professional | None | $0.89 | $1.00 | $3.24 |
Tufts Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $1.82 | Facility | None | $1.62 | $1.62 | $1.82 |
United Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $3.24 | Professional | None | $0.89 | $0.89 | $3.24 |
Well Sense Setting Facility Modifier None Typical Low $0.89 Median $1.41 Typical High $2.34 | Facility | None | $0.89 | $1.41 | $2.34 |
Well Sense Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.20 | Professional | None | $1.00 | $1.00 | $1.20 |
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 $0.50 Median $0.50 Typical High $0.52 | Professional | 52 · Reduced service | $0.50 | $0.50 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Where Massachusetts sits
The same service costs 2.5 times more in Texas 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· 18th of 51
$1.10
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.