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 $1.20 Median $1.20 Typical High $1.95 | Facility | None | $1.20 | $1.20 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.20 Median $1.95 Typical High $2.24 | Professional | None | $1.20 | $1.95 | $2.24 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.52 Median $4.90 Typical High $6.31 | Facility | None | $0.52 | $4.90 | $6.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.36 Median $0.91 Typical High $1.95 | Professional | None | $0.36 | $0.91 | $1.95 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.95 Median $2.19 Typical High $3.98 | Facility | None | $1.95 | $2.19 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $2.51 Median $4.07 Typical High $8.51 | Facility | None | $2.51 | $4.07 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
Fallon Health Setting Facility Modifier None Typical Low $1.95 Median $2.51 Typical High $3.02 | Facility | None | $1.95 | $2.51 | $3.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.36 Median $0.91 Typical High $1.95 | Professional | None | $0.36 | $0.91 | $1.95 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.52 Median $4.90 Typical High $6.31 | Facility | None | $0.52 | $4.90 | $6.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.36 Median $0.91 Typical High $1.95 | Professional | None | $0.36 | $0.91 | $1.95 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.91 Typical High $1.38 | Professional | None | $0.36 | $0.91 | $1.38 |
Well Sense Setting Facility Modifier None Typical Low $1.02 Median $2.45 Typical High $4.47 | Facility | None | $1.02 | $2.45 | $4.47 |
Well Sense Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.34 | Professional | None | $1.95 | $1.95 | $2.34 |
2 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 55 · Aftercare only Typical Low $0.18 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.18 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.12 | $0.19 | $0.19 |
Where Massachusetts sits
The same service costs 2.3 times more in Arkansas than in North Carolina. 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· 42nd of 51
$1.55
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.