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 $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.23 Median $4.68 Typical High $6.03 | Facility | None | $1.23 | $4.68 | $6.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.29 | Professional | None | $1.86 | $1.86 | $2.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.86 Median $2.14 Typical High $3.80 | Facility | None | $1.86 | $2.14 | $3.80 |
Cigna Setting Facility Modifier None Typical Low $2.40 Median $3.89 Typical High $8.13 | Facility | None | $2.40 | $3.89 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Fallon Health Setting Facility Modifier None Typical Low $1.86 Median $2.40 Typical High $2.88 | Facility | None | $1.86 | $2.40 | $2.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.23 Median $4.68 Typical High $6.03 | Facility | None | $1.23 | $4.68 | $6.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.29 | Professional | None | $1.86 | $1.86 | $2.29 |
United Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Well Sense Setting Facility Modifier None Typical Low $1.86 Median $2.57 Typical High $3.80 | Facility | None | $1.86 | $2.57 | $3.80 |
Well Sense Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.51 | Professional | None | $1.86 | $1.86 | $2.51 |
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 $0.93 Median $0.93 Typical High $0.93 | Professional | 52 · Reduced service | $0.93 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 53 · Discontinued | $0.37 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.19 |
Where Massachusetts sits
Rates are fairly even across states for this service. 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· 20th of 51
$1.86
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.