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 $11.22 Median $11.48 Typical High $19.95 | Facility | None | $11.22 | $11.48 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.18 | Professional | None | $11.48 | $11.48 | $13.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $12.30 Median $12.59 Typical High $37.15 | Facility | None | $12.30 | $12.59 | $37.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $11.48 Median $11.75 Typical High $17.38 | Professional | None | $11.48 | $11.75 | $17.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $11.48 Median $12.88 Typical High $23.44 | Facility | None | $11.48 | $12.88 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $23.99 Typical High $48.98 | Facility | None | $14.79 | $23.99 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $16.22 | Professional | None | $11.48 | $11.48 | $16.22 |
Fallon Health Setting Facility Modifier None Typical Low $11.48 Median $15.49 Typical High $23.44 | Facility | None | $11.48 | $15.49 | $23.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $11.48 Median $11.75 Typical High $19.50 | Professional | None | $11.48 | $11.75 | $19.50 |
Mass General Brigham Setting Facility Modifier None Typical Low $12.30 Median $12.59 Typical High $37.15 | Facility | None | $12.30 | $12.59 | $37.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $11.48 Median $11.75 Typical High $17.38 | Professional | None | $11.48 | $11.75 | $17.38 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $19.50 | Professional | None | $11.75 | $11.75 | $19.50 |
Well Sense Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $26.30 | Facility | None | $12.88 | $16.22 | $26.30 |
Well Sense Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
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 $5.62 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.12 |
Where Massachusetts sits
The same service costs 1.8 times more in Alaska than in Georgia. 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· 25th of 51
$12.30
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.