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 $1.74 Median $1.74 Typical High $2.29 | Facility | None | $1.74 | $1.74 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.82 | Professional | None | $1.74 | $1.74 | $1.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.58 Median $4.37 Typical High $5.75 | Facility | None | $1.58 | $4.37 | $5.75 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.58 Median $1.70 Typical High $2.51 | Professional | None | $1.58 | $1.70 | $2.51 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.74 Median $2.00 Typical High $3.63 | Facility | None | $1.74 | $2.00 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $2.24 Median $3.63 Typical High $7.59 | Facility | None | $2.24 | $3.63 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
Fallon Health Setting Facility Modifier None Typical Low $1.74 Median $2.29 Typical High $2.63 | Facility | None | $1.74 | $2.29 | $2.63 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.26 Median $1.58 Typical High $2.51 | Professional | None | $1.26 | $1.58 | $2.51 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.58 Median $4.37 Typical High $5.75 | Facility | None | $1.58 | $4.37 | $5.75 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.58 Median $1.70 Typical High $2.51 | Professional | None | $1.58 | $1.70 | $2.51 |
United Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.70 Typical High $2.88 | Professional | None | $1.58 | $1.70 | $2.88 |
Well Sense Setting Facility Modifier None Typical Low $1.86 Median $2.34 Typical High $4.07 | Facility | None | $1.86 | $2.34 | $4.07 |
Well Sense Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.09 | Professional | None | $1.74 | $1.74 | $2.09 |
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 $0.87 Median $0.87 Typical High $0.91 | Professional | 52 · Reduced service | $0.87 | $0.87 | $0.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.35 Typical High $0.36 | Professional | 53 · Discontinued | $0.35 | $0.35 | $0.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.26 Typical High $0.27 | Professional | 55 · Aftercare only | $0.26 | $0.26 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.18 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in Mississippi. 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· 40th of 51
$1.74
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.