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 $5.62 Median $5.62 Typical High $14.79 | Facility | None | $5.62 | $5.62 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | None | $5.62 | $5.62 | $5.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $14.13 Median $18.20 Typical High $19.95 | Facility | None | $14.13 | $18.20 | $19.95 |
AllWays Health Partners Setting Professional Modifier None Typical Low $5.62 Median $5.89 Typical High $33.11 | Professional | None | $5.62 | $5.89 | $33.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $5.62 Median $6.31 Typical High $11.48 | Facility | None | $5.62 | $6.31 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $11.75 Typical High $24.55 | Facility | None | $7.24 | $11.75 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $9.33 | Professional | None | $5.62 | $5.62 | $9.33 |
Fallon Health Setting Facility Modifier None Typical Low $5.62 Median $7.24 Typical High $8.71 | Facility | None | $5.62 | $7.24 | $8.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $5.62 Median $5.89 Typical High $18.62 | Professional | None | $5.62 | $5.89 | $18.62 |
Mass General Brigham Setting Facility Modifier None Typical Low $14.13 Median $18.20 Typical High $19.95 | Facility | None | $14.13 | $18.20 | $19.95 |
Mass General Brigham Setting Professional Modifier None Typical Low $5.62 Median $5.89 Typical High $33.11 | Professional | None | $5.62 | $5.89 | $33.11 |
United Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $33.11 | Professional | None | $5.89 | $5.89 | $33.11 |
Well Sense Setting Facility Modifier None Typical Low $6.46 Median $8.13 Typical High $12.88 | Facility | None | $6.46 | $8.13 | $12.88 |
Well Sense Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $6.76 | Professional | None | $5.62 | $5.62 | $6.76 |
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 $2.82 Median $2.82 Typical High $2.95 | Professional | 52 · Reduced service | $2.82 | $2.82 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.17 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $0.87 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.58 |
Where Massachusetts sits
The same service costs 3.2 times more in Oklahoma than in North Dakota. 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
$6.03
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.