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 $1.58 Median $1.58 Typical High $2.95 | Facility | None | $1.58 | $1.58 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.66 | Professional | None | $1.58 | $1.58 | $1.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.48 Median $3.98 Typical High $5.13 | Facility | None | $1.48 | $3.98 | $5.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.34 | Professional | None | $1.58 | $1.58 | $2.34 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.58 Median $1.82 Typical High $3.24 | Facility | None | $1.58 | $1.82 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $2.04 Median $3.31 Typical High $6.92 | Facility | None | $2.04 | $3.31 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.95 | Professional | None | $1.58 | $1.58 | $1.95 |
Fallon Health Setting Facility Modifier None Typical Low $1.58 Median $2.04 Typical High $2.34 | Facility | None | $1.58 | $2.04 | $2.34 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.32 Median $1.58 Typical High $2.63 | Professional | None | $1.32 | $1.58 | $2.63 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.48 Median $3.98 Typical High $5.13 | Facility | None | $1.48 | $3.98 | $5.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.34 | Professional | None | $1.58 | $1.58 | $2.34 |
United Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.63 | Professional | None | $1.58 | $1.58 | $2.63 |
Well Sense Setting Facility Modifier None Typical Low $1.74 Median $2.19 Typical High $3.72 | Facility | None | $1.74 | $2.19 | $3.72 |
Well Sense Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.91 | Professional | None | $1.58 | $1.58 | $1.91 |
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 $0.79 Median $0.79 Typical High $0.81 | Professional | 52 · Reduced service | $0.79 | $0.79 | $0.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.33 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.25 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.16 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in Alabama. 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
$1.58
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.