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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $28.84 Median $72.44 Typical High $93.33 | Facility | None | $28.84 | $72.44 | $93.33 |
AllWays Health Partners Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $51.29 | Professional | None | $28.84 | $33.88 | $51.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $30.20 Median $33.88 Typical High $61.66 | Facility | None | $30.20 | $33.88 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $60.26 Typical High $125.89 | Facility | None | $37.15 | $60.26 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $36.31 | Professional | None | $28.84 | $28.84 | $36.31 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $83.18 | Facility | None | $56.23 | $83.18 | $83.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $57.54 | Professional | None | $30.20 | $33.88 | $57.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $28.84 Median $72.44 Typical High $93.33 | Facility | None | $28.84 | $72.44 | $93.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $51.29 | Professional | None | $28.84 | $33.88 | $51.29 |
United Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $57.54 | Professional | None | $28.84 | $33.88 | $57.54 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in Oklahoma. 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· 22nd of 51
$33.88
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.