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 $12.30 Median $12.30 Typical High $33.88 | Facility | None | $12.30 | $12.30 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
AllWays Health Partners Setting Facility Modifier None Typical Low $12.02 Median $35.48 Typical High $42.66 | Facility | None | $12.02 | $35.48 | $42.66 |
AllWays Health Partners Setting Professional Modifier None Typical Low $12.02 Median $14.45 Typical High $21.88 | Professional | None | $12.02 | $14.45 | $21.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $30.20 | Facility | None | $14.45 | $16.60 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $30.20 Typical High $63.10 | Facility | None | $18.62 | $30.20 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $18.20 | Professional | None | $14.45 | $14.45 | $18.20 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $83.18 | Facility | None | $56.23 | $83.18 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $26.30 | Professional | None | $14.45 | $14.45 | $26.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $12.02 Median $35.48 Typical High $42.66 | Facility | None | $12.02 | $35.48 | $42.66 |
Mass General Brigham Setting Professional Modifier None Typical Low $12.02 Median $14.45 Typical High $21.88 | Professional | None | $12.02 | $14.45 | $21.88 |
United Setting Professional Modifier None Typical Low $12.59 Median $14.45 Typical High $21.88 | Professional | None | $12.59 | $14.45 | $21.88 |
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 $6.17 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 53 · Discontinued | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.23 |
Where Massachusetts sits
The same service costs 2.1 times more in Kansas than in Utah. 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· 43rd of 51
$14.45
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.