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 $2.45 Median $2.45 Typical High $4.17 | Facility | None | $2.45 | $2.45 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.57 | Professional | None | $2.45 | $2.45 | $2.57 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2.19 Median $6.17 Typical High $7.94 | Facility | None | $2.19 | $6.17 | $7.94 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.40 Median $2.45 Typical High $3.63 | Professional | None | $2.40 | $2.45 | $3.63 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $2.45 Median $2.82 Typical High $5.01 | Facility | None | $2.45 | $2.82 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $5.13 Typical High $10.72 | Facility | None | $3.16 | $5.13 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.88 | Professional | None | $2.45 | $2.45 | $2.88 |
Fallon Health Setting Facility Modifier None Typical Low $2.45 Median $3.16 Typical High $3.72 | Facility | None | $2.45 | $3.16 | $3.72 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.04 Median $2.40 Typical High $4.07 | Professional | None | $2.04 | $2.40 | $4.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $2.19 Median $6.17 Typical High $7.94 | Facility | None | $2.19 | $6.17 | $7.94 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.40 Median $2.45 Typical High $3.63 | Professional | None | $2.40 | $2.45 | $3.63 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $4.07 | Professional | None | $2.40 | $2.40 | $4.07 |
Well Sense Setting Facility Modifier None Typical Low $2.63 Median $3.39 Typical High $5.75 | Facility | None | $2.63 | $3.39 | $5.75 |
Well Sense Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
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 $1.23 Median $1.23 Typical High $1.26 | Professional | 52 · Reduced service | $1.23 | $1.23 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.49 Median $0.49 Typical High $0.51 | Professional | 53 · Discontinued | $0.49 | $0.49 | $0.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.38 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in Iowa. 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· 27th of 51
$2.45
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.