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 $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.66 | Professional | None | $0.58 | $0.58 | $0.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.65 Median $1.17 Typical High $1.91 | Facility | None | $0.65 | $1.17 | $1.91 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.58 Median $0.68 Typical High $2.34 | Professional | None | $0.58 | $0.68 | $2.34 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.58 Median $0.66 Typical High $1.20 | Facility | None | $0.58 | $0.66 | $1.20 |
Cigna Setting Facility Modifier None Typical Low $0.76 Median $1.23 Typical High $2.51 | Facility | None | $0.76 | $1.23 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.72 | Professional | None | $0.58 | $0.58 | $0.72 |
Fallon Health Setting Facility Modifier None Typical Low $0.58 Median $0.81 Typical High $1.00 | Facility | None | $0.58 | $0.81 | $1.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.58 Median $0.68 Typical High $2.34 | Professional | None | $0.58 | $0.68 | $2.34 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.65 Median $1.17 Typical High $1.91 | Facility | None | $0.65 | $1.17 | $1.91 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.58 Median $0.68 Typical High $2.34 | Professional | None | $0.58 | $0.68 | $2.34 |
United Setting Facility Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $2.34 | Professional | None | $0.68 | $0.68 | $2.34 |
Well Sense Setting Facility Modifier None Typical Low $0.71 Median $0.93 Typical High $1.35 | Facility | None | $0.71 | $0.93 | $1.35 |
Well Sense Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.71 | Professional | None | $0.58 | $0.58 | $0.71 |
5 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 $0.28 Median $0.28 Typical High $0.28 | Professional | 52 · Reduced service | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 54 · Surgery only | $0.44 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Massachusetts sits
The same service costs 4.1 times more in Wyoming than in Delaware. 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
$0.68
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.