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 $56.23 Median $56.23 Typical High $63.10 | Facility | None | $56.23 | $56.23 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | None | $56.23 | $56.23 | $58.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $42.66 Median $141.25 Typical High $186.21 | Facility | None | $42.66 | $141.25 | $186.21 |
AllWays Health Partners Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $67.61 | Professional | None | $21.88 | $54.95 | $67.61 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $56.23 Median $64.57 Typical High $117.49 | Facility | None | $56.23 | $64.57 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $120.23 Typical High $245.47 | Facility | None | $72.44 | $120.23 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | None | $56.23 | $56.23 | $66.07 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $74.13 Typical High $85.11 | Facility | None | $56.23 | $74.13 | $85.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $21.88 Median $56.23 Typical High $93.33 | Professional | None | $21.88 | $56.23 | $93.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $42.66 Median $141.25 Typical High $186.21 | Facility | None | $42.66 | $141.25 | $186.21 |
Mass General Brigham Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $67.61 | Professional | None | $21.88 | $54.95 | $67.61 |
United Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $83.18 | Professional | None | $21.88 | $54.95 | $83.18 |
Well Sense Setting Facility Modifier None Typical Low $54.95 Median $69.18 Typical High $125.89 | Facility | None | $54.95 | $69.18 | $125.89 |
Well Sense Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | None | $56.23 | $56.23 | $67.61 |
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 $28.18 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.75 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.89 |
Well Sense Setting Facility Modifier KO · Single-drug unit dose Typical Low $70.79 Median $85.11 Typical High $131.83 | Facility | KO · Single-drug unit dose | $70.79 | $85.11 | $131.83 |
Where Massachusetts sits
The same service costs 1.6 times more in Alaska than in Louisiana. 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
$56.23
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.