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 $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.89 | Professional | None | $3.72 | $3.72 | $3.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.39 Median $9.33 Typical High $12.02 | Facility | None | $3.39 | $9.33 | $12.02 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.55 Median $3.72 Typical High $5.37 | Professional | None | $3.55 | $3.72 | $5.37 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $3.72 Median $4.27 Typical High $7.59 | Facility | None | $3.72 | $4.27 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $7.76 Typical High $16.22 | Facility | None | $4.79 | $7.76 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.47 | Professional | None | $3.72 | $3.72 | $4.47 |
Fallon Health Setting Facility Modifier None Typical Low $3.72 Median $4.79 Typical High $5.62 | Facility | None | $3.72 | $4.79 | $5.62 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $6.03 | Professional | None | $3.47 | $3.55 | $6.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.39 Median $9.33 Typical High $12.02 | Facility | None | $3.39 | $9.33 | $12.02 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.55 Median $3.72 Typical High $5.37 | Professional | None | $3.55 | $3.72 | $5.37 |
United Setting Facility Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $6.03 | Professional | None | $3.55 | $3.55 | $6.03 |
Well Sense Setting Facility Modifier None Typical Low $3.98 Median $5.50 Typical High $8.71 | Facility | None | $3.98 | $5.50 | $8.71 |
Well Sense Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.47 | Professional | None | $3.72 | $3.72 | $4.47 |
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 $1.86 Median $1.86 Typical High $1.86 | Professional | 52 · Reduced service | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.74 Typical High $0.74 | Professional | 53 · Discontinued | $0.74 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.37 | $0.37 | $0.37 |
Where Massachusetts sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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
$3.72
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.