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 $1.51 Median $1.51 Typical High $3.31 | Facility | None | $1.51 | $1.51 | $3.31 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.58 | Professional | None | $1.51 | $1.51 | $1.58 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.51 Median $3.80 Typical High $4.90 | Facility | None | $1.51 | $3.80 | $4.90 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.48 Median $1.51 Typical High $2.29 | Professional | None | $1.48 | $1.51 | $2.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.51 Median $1.74 Typical High $3.09 | Facility | None | $1.51 | $1.74 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $1.95 Median $3.16 Typical High $6.61 | Facility | None | $1.95 | $3.16 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.86 | Professional | None | $1.51 | $1.51 | $1.86 |
Fallon Health Setting Facility Modifier None Typical Low $1.51 Median $1.95 Typical High $2.34 | Facility | None | $1.51 | $1.95 | $2.34 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.48 Median $1.51 Typical High $2.75 | Professional | None | $1.48 | $1.51 | $2.75 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.51 Median $3.80 Typical High $4.90 | Facility | None | $1.51 | $3.80 | $4.90 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.48 Median $1.51 Typical High $2.29 | Professional | None | $1.48 | $1.51 | $2.29 |
United Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
United Setting Professional Modifier None Typical Low $1.48 Median $1.51 Typical High $2.57 | Professional | None | $1.48 | $1.51 | $2.57 |
Well Sense Setting Facility Modifier None Typical Low $1.78 Median $2.09 Typical High $3.09 | Facility | None | $1.78 | $2.09 | $3.09 |
Well Sense Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.82 | Professional | None | $1.51 | $1.51 | $1.82 |
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 $0.76 Median $0.76 Typical High $0.79 | Professional | 52 · Reduced service | $0.76 | $0.76 | $0.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.30 Typical High $0.31 | Professional | 53 · Discontinued | $0.30 | $0.30 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.24 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.16 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in North Carolina. 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· 39th of 51
$1.51
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.