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 $0.85 Median $1.20 Typical High $2.14 | Facility | None | $0.85 | $1.20 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.41 | Professional | None | $1.23 | $1.23 | $1.41 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.85 Median $3.39 Typical High $10.96 | Facility | None | $0.85 | $3.39 | $10.96 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.23 Median $1.29 Typical High $3.63 | Professional | None | $1.23 | $1.29 | $3.63 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.23 Median $1.38 Typical High $2.51 | Facility | None | $1.23 | $1.38 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $2.51 Typical High $5.25 | Facility | None | $1.55 | $2.51 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
Fallon Health Setting Facility Modifier None Typical Low $1.23 Median $1.58 Typical High $1.91 | Facility | None | $1.23 | $1.58 | $1.91 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.23 Median $1.29 Typical High $3.63 | Professional | None | $1.23 | $1.29 | $3.63 |
Health New England Setting Facility Modifier None Typical Low $1.62 Median $3.24 Typical High $7.76 | Facility | None | $1.62 | $3.24 | $7.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.85 Median $3.39 Typical High $10.96 | Facility | None | $0.85 | $3.39 | $10.96 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.23 Median $1.29 Typical High $3.63 | Professional | None | $1.23 | $1.29 | $3.63 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $3.63 | Professional | None | $1.29 | $1.29 | $3.63 |
Well Sense Setting Facility Modifier None Typical Low $1.41 Median $1.78 Typical High $2.82 | Facility | None | $1.41 | $1.78 | $2.82 |
Well Sense Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.45 | Professional | None | $1.23 | $1.23 | $1.45 |
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 $0.62 Median $0.62 Typical High $0.62 | Professional | 52 · Reduced service | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | 53 · Discontinued | $0.24 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.12 |
Where Massachusetts sits
The same service costs 3.4 times more in Texas than in Oklahoma. 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· 29th of 51
$1.29
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.